WorldWideScience

Sample records for surgical skills training

  1. Evolution of surgical skills training

    Science.gov (United States)

    Roberts, Kurt E; Bell, Robert L; Duffy, Andrew J

    2006-01-01

    Surgical training is changing: one hundred years of tradition is being challenged by legal and ethical concerns for patient safety, work hours restrictions, the cost of operating room time, and complications. Surgical simulation and skills training offers an opportunity to teach and practice advanced skills outside of the operating room environment before attempting them on living patients. Simulation training can be as straight forward as using real instruments and video equipment to manipulate simulated “tissue” in a box trainer. More advanced, virtual reality simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations. The Accreditation Council of Graduate Medical Education’s (ACGME) has mandated the development of novel methods of training and evaluation. Surgical organizations are calling for methods to ensure the maintenance of skills, advance surgical training, and to credential surgeons as technically competent. Simulators in their current form have been demonstrated to improve the operating room performance of surgical residents. Development of standardized training curricula remains an urgent and important agenda, particularly for minimal invasive surgery. An innovative and progressive approach, borrowing experiences from the field of aviation, can provide the foundation for the next century of surgical training, ensuring the quality of the product. As the technology develops, the way we practice will continue to evolve, to the benefit of physicians and patients. PMID:16718842

  2. Using dummies for surgical skills training

    DEFF Research Database (Denmark)

    Langebæk, Rikke

    2011-01-01

    Effective acquisition of a skill requires practise. Therefore it is of great importance to provide veterinary students with opportunities to practice their surgical skills before carrying out surgical procedures on live patients. Some veterinary schools let students perform entire surgical...... procedures on research animals, in order to learn the basic skills along the way. From an ethical point of view it is questionable however to use live research animals for the sole purpose of practising surgery, and also, research animals are very costly. It is therefore necessary to identify alternative...... teaching methods for veterinary surgical training. At the Department of Small Animal Clinical Sciences, Faculty of Life Sciences, a number of low fidelity, stuffed toy animal dummies was developed for the Surgical Skills Lab in order to teach 4th year students the basic surgical skills. In the Surgical...

  3. Surgical simulation in orthopaedic skills training.

    Science.gov (United States)

    Atesok, Kivanc; Mabrey, Jay D; Jazrawi, Laith M; Egol, Kenneth A

    2012-07-01

    Mastering rapidly evolving orthopaedic surgical techniques requires a lengthy period of training. Current work-hour restrictions and cost pressures force trainees to face the challenge of acquiring more complex surgical skills in a shorter amount of time. As a result, alternative methods to improve the surgical skills of orthopaedic trainees outside the operating room have been developed. These methods include hands-on training in a laboratory setting using synthetic bones or cadaver models as well as software tools and computerized simulators that enable trainees to plan and simulate orthopaedic operations in a three-dimensional virtual environment. Laboratory-based training offers potential benefits in the development of basic surgical skills, such as using surgical tools and implants appropriately, achieving competency in procedures that have a steep learning curve, and assessing already acquired skills while minimizing concerns for patient safety, operating room time, and financial constraints. Current evidence supporting the educational advantages of surgical simulation in orthopaedic skills training is limited. Despite this, positive effects on the overall education of orthopaedic residents, and on maintaining the proficiency of practicing orthopaedic surgeons, are anticipated.

  4. 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.

  5. [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.

  6. 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....

  7. 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…

  8. Cost-effective framework for basic surgical skills training.

    Science.gov (United States)

    Jiang, Deng-Jin; Wen, Chan; Yang, Ai-Jun; Zhu, Zhi-Li; Lei, Yan; Lan, Yang-Jun; Huang, Qing-Yuan; Hou, Xiao-Yu

    2013-06-01

    The importance of basic surgical skills is entirely agreed among surgical educators. However, restricted by ethical issues, finance etc, the basic surgical skills training is increasingly challenged. Increasing cost gives an impetus to the development of cost-effective training models to meet the trainees' acquisition of basic surgical skills. In this situation, a cost-effective training framework was formed in our department and introduced here. Each five students were assigned to a 'training unit'. The training was implemented weekly for 18 weeks. The framework consisted of an early, a transitional, an integrative stage and a surgical skills competition. Corresponding training modules were selected and assembled scientifically at each stage. The modules comprised campus intranet databases, sponge benchtop, nonliving animal tissue, local dissection specimens and simulating reality operations. The training outcomes used direct observation of procedural skills as an assessment tool. The training data of 50 trainees who were randomly selected in each year from 2006 to 2011 year, were retrospectively analysed. An excellent and good rate of the surgical skills is from 82 to 88%, but there is no significant difference among 6 years (P > 0.05). The skills scores of the contestants are markedly higher than those of non-contestants (P < 0.05). The average training cost per trainee is about $21.85-34.08. The present training framework is reliable, feasible, repeatable and cost-effective. The skills competition can promote to improve the surgical skills level of trainees. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  9. 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. Mobile surgical skills education unit: a new concept in surgical training.

    Science.gov (United States)

    Shaikh, Faisal M; Hseino, Hazem; Hill, Arnold D K; Kavanagh, Eamon; Traynor, Oscar

    2011-08-01

    Basic surgical skills are an integral part of surgical training. Simulation-based surgical training offers an opportunity both to trainees and trainers to learn and teach surgical skills outside the operating room in a nonpatient, nonstressed environment. However, widespread adoption of simulation technology especially in medical education is prohibited by its inherent higher cost, limited space, and interruptions to clinical duties. Mobile skills laboratory has been proposed as a means to address some of these limitations. A new program is designed by the Royal College of Surgeons in Ireland (RCSI), in an approach to teach its postgraduate basic surgical trainees the necessary surgical skills, by making the use of mobile innovative simulation technology in their own hospital settings. In this article, authors describe the program and students response to the mobile surgical skills being delivered in the region of their training hospitals and by their own regional consultant trainers.

  11. 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.

  12. The role of multimedia in surgical skills training and assessment.

    Science.gov (United States)

    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.

  13. 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...

  14. 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.

  15. [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

  16. Surgical and procedural skills training at medical school - a national review.

    Science.gov (United States)

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

    2014-01-01

    This national study quantifies procedural and surgical skills training at medical schools in the United Kingdom (UK), a stipulated requirement of all graduates by the General Medical Council (GMC). A questionnaire recorded basic procedural and surgical skills training provided by medical schools and surgical societies in the UK. Skills were extracted from (1) GMC Tomorrows Doctors and (2) The Royal College of Surgeons Intercollegiate Basic Surgical Skills (BSS) course. Data from medical school curricula and extra-curricular student surgical societies were compared against the national GMC guidelines and BSS course content. Data were analysed using Mann-Whitney U tests. Representatives from 23 medical schools completed the survey (71.9% response). Thirty one skills extracted from the BSS course were split into 5 categories, with skills content cross referenced against GMC documentation. Training of surgical skills by medical schools was as follows: Gowning and gloving (72.8%), handling instruments (29.4%), knot tying (17.4%), suturing (24.7%), other surgical techniques (4.3%). Surgical societies provided significantly more training of knot tying (64.4%, P = 0.0013) and suturing (64.5%, P = 0.0325) than medical schools. Medical schools provide minimal basic surgical skills training, partially supplemented by extracurricular student surgical societies. Our findings suggest senior medical students do not possess simple surgical and procedural skills. Newly qualified doctors are at risk of being unable to safely perform practical procedures, contradicting GMC Guidelines. We propose a National Undergraduate Curriculum in Surgery and Surgical Skills to equip newly qualified doctors with basic procedural skills to maximise patient safety. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  20. Acquiring minimally invasive surgical skills

    OpenAIRE

    Hiemstra, Ellen

    2012-01-01

    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room. This thesis has led to an enlarged insight in the organization of surgical skills training during residency training of surgical medical specialists.

  1. 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

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. Acquiring minimally invasive surgical skills

    NARCIS (Netherlands)

    Hiemstra, Ellen

    2012-01-01

    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  10. 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.

  11. 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.

  12. 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.

  13. 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....

  14. 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.

  15. [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.

  16. 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.

  17. 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

  18. Systematic review of serious games for medical education and surgical skills training

    NARCIS (Netherlands)

    Graafland, M.; Schraagen, J.M.C.; Schijven, M.P.

    2012-01-01

    Background: The application of digital games for training medical professionals is on the rise. So-called ‘serious’ games form training tools that provide a challenging simulated environment, ideal for future surgical training. Ultimately, serious games are directed at reducing medical error and

  19. 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.

  20. "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.

  1. 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.

  2. Saturated salt solution method: a useful cadaver embalming for surgical skills training.

    Science.gov (United States)

    Hayashi, Shogo; Homma, Hiroshi; Naito, Munekazu; Oda, Jun; Nishiyama, Takahisa; Kawamoto, Atsuo; Kawata, Shinichi; Sato, Norio; Fukuhara, Tomomi; Taguchi, Hirokazu; Mashiko, Kazuki; Azuhata, Takeo; Ito, Masayuki; Kawai, Kentaro; Suzuki, Tomoya; Nishizawa, Yuji; Araki, Jun; Matsuno, Naoto; Shirai, Takayuki; Qu, Ning; Hatayama, Naoyuki; Hirai, Shuichi; Fukui, Hidekimi; Ohseto, Kiyoshige; Yukioka, Tetsuo; Itoh, Masahiro

    2014-12-01

    This article evaluates the suitability of cadavers embalmed by the saturated salt solution (SSS) method for surgical skills training (SST). SST courses using cadavers have been performed to advance a surgeon's techniques without any risk to patients. One important factor for improving SST is the suitability of specimens, which depends on the embalming method. In addition, the infectious risk and cost involved in using cadavers are problems that need to be solved. Six cadavers were embalmed by 3 methods: formalin solution, Thiel solution (TS), and SSS methods. Bacterial and fungal culture tests and measurement of ranges of motion were conducted for each cadaver. Fourteen surgeons evaluated the 3 embalming methods and 9 SST instructors (7 trauma surgeons and 2 orthopedists) operated the cadavers by 21 procedures. In addition, ultrasonography, central venous catheterization, and incision with cauterization followed by autosuture stapling were performed in some cadavers. The SSS method had a sufficient antibiotic effect and produced cadavers with flexible joints and a high tissue quality suitable for SST. The surgeons evaluated the cadavers embalmed by the SSS method to be highly equal to those embalmed by the TS method. Ultrasound images were clear in the cadavers embalmed by both the methods. Central venous catheterization could be performed in a cadaver embalmed by the SSS method and then be affirmed by x-ray. Lungs and intestines could be incised with cauterization and autosuture stapling in the cadavers embalmed by TS and SSS methods. Cadavers embalmed by the SSS method are sufficiently useful for SST. This method is simple, carries a low infectious risk, and is relatively of low cost, enabling a wider use of cadavers for SST.

  3. 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.

  4. 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.

  5. 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.

  6. Impact of continuous training through distributed practice for acquisition of minimally invasive surgical skills.

    Science.gov (United States)

    Nakata, Bruce Negrello; Cavalini, Worens; Bonin, Eduardo A; Salvalaggio, Paolo R; Loureiro, Marcelo P

    2017-10-01

    Minimally invasive surgery (MIS) requires the mastery of manual skills and a specific training is required. Apart from residencies and fellowships in MIS, other learning opportunities utilize massive training, mainly with use of simulators in short courses. A long-term postgraduate course represents an opportunity to learn through training using distributed practice. The objective of this study is to assess the use of distributed practice for acquisition of basic minimally invasive skills in surgeons who participated in a long-term MIS postgraduate course. A prospective, longitudinal and quantitative study was conducted among surgeons who attended a 1-year postgraduate course of MIS in Brazil, from 2012 to 2014. They were tested through five different exercises in box trainers (peg-transfer, passing, cutting, intracorporeal knot, and suture) in the first (t0), fourth (t1) and last, eighth, (t2) meetings of this course. The time and penalties of each exercise were collected for each participant. Participant skills were assessed based on time and accuracy on a previously tested score. Fifty-seven surgeons (participants) from three consecutive groups participated in this study. There was a significant improvement in scores in all exercises. The average increase in scores between t0 and t2 was 88% for peg-transfer, 174% for passing, 149% for cutting, 130% for intracorporeal knot, and 120% for suture (p < 0.001 for all exercises). Learning through distributed practice is effective and should be integrated into a MIS postgraduate course curriculum for acquisition of core skills.

  7. 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.

  8. 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.

  9. Outlier experienced surgeon's performances impact on benchmark for technical surgical skills training.

    Science.gov (United States)

    Gallagher, Anthony G; Henn, Patrick J; Neary, Paul C; Senagore, Anthony J; Marcello, Peter W; Bunting, Brendan P; Seymour, Neal E; Satava, Richard M

    2018-03-23

    Training in medicine must move to an outcome-based approach. A proficiency-based progression outcome approach to training relies on a quantitative estimation of experienced operator performance. We aimed to develop a method for dealing with atypical expert performances in the quantitative definition of surgical proficiency. In study one, 100 experienced laparoscopic surgeons' performances on virtual reality and box-trainer simulators were assessed for two similar laparoscopic tasks. In study two, 15 experienced surgeons and 16 trainee colorectal surgeons performed one simulated hand-assisted laparoscopic colorectal procedure. Performance scores of experienced surgeons in both studies were standardized (i.e. Z-scores) using the mean and standard deviations (SDs). Performances >1.96 SDs from the mean were excluded in proficiency definitions. In study one, 1-5% of surgeons' performances were excluded having performed significantly below their colleagues. Excluded surgeons made significantly fewer correct incisions (mean = 7 (SD = 2) versus 19.42 (SD = 4.6), P 4 SDs for time to complete the procedure and >6 SDs for path length. After their exclusions, experienced surgeons' performances were significantly better than trainees for path length: P = 0.031 and for time: P = 0.002. Objectively assessed atypical expert performances were few. Z-score standardization identified them and produced a more robust quantitative definition of proficiency. © 2018 Royal Australasian College of Surgeons.

  10. Assessment of Surgical Skills and Competency.

    Science.gov (United States)

    Bhatti, Nasir I

    2017-10-01

    Evaluation of surgical skills and competency are important aspects of the medical education process. Measurable and reproducible methods of assessment with objective feedback are essential components of surgical training. Objective Structured Assessment of Technical Skills (OSATS) is widely used across the medical specialties and otolaryngology-specific tools have been developed and validated for sinus and mastoid surgery. Although assessment of surgical skills can be time-consuming and requires human and financial resources, new evaluation methods and emerging technology may alleviate these barriers while also improving data collection practices. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    NARCIS (Netherlands)

    Ganni, S.; Chmarra, M.K.; Goossens, R.H.M.; Jakimowicz, J.J.

    2017-01-01

    Background: 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

  12. Development of a virtual reality haptic Veress needle insertion simulator for surgical skills training.

    Science.gov (United States)

    Okrainec, A; Farcas, M; Henao, O; Choy, I; Green, J; Fotoohi, M; Leslie, R; Wight, D; Karam, P; Gonzalez, N; Apkarian, J

    2009-01-01

    The Veress needle is the most commonly used technique for creating the pneumoperitoneum at the start of a laparoscopic surgical procedure. Inserting the Veress needle correctly is crucial since errors can cause significant harm to patients. Unfortunately, this technique can be difficult to teach since surgeons rely heavily on tactile feedback while advancing the needle through the various layers of the abdominal wall. This critical step in laparoscopy, therefore, can be challenging for novice trainees to learn without adequate opportunities to practice in a safe environment with no risk of injury to patients. To address this issue, we have successfully developed a prototype of a virtual reality haptic needle insertion simulator using the tactile feedback of 22 surgeons to set realistic haptic parameters. A survey of these surgeons concluded that our device appeared and felt realistic, and could potentially be a useful tool for teaching the proper technique of Veress needle insertion.

  13. Surgical Skills Beyond Scientific Management.

    Science.gov (United States)

    Whitfield, Nicholas

    2015-07-01

    During the Great War, the French surgeon Alexis Carrel, in collaboration with the English chemist Henry Dakin, devised an antiseptic treatment for infected wounds. This paper focuses on Carrel's attempt to standardise knowledge of infected wounds and their treatment, and looks closely at the vision of surgical skill he espoused and its difference from those associated with the doctrines of scientific management. Examining contemporary claims that the Carrel-Dakin method increased rather than diminished demands on surgical work, this paper further shows how debates about antiseptic wound treatment opened up a critical space for considering the nature of skill as a vital dynamic in surgical innovation and practice.

  14. Communication Skills Training for Surgical Residents: Learning to Relate to the Needs of Older Adults.

    Science.gov (United States)

    Roberts, Linda; Cornell, Charles; Bostrom, Mathias; Goldsmith, Sandra; Ologhobo, Titilayo; Roberts, Timothy; Robbins, Laura

    2018-03-30

    It is vital for physicians and surgeons to communicate successfully with older adults, who will constitute one-fifth of the US population by 2030. Older adults often perceive themselves as stigmatized and powerless in healthcare settings. Effective communication leads to better patient compliance and satisfaction, which is now a component of Medicare hospital reimbursement and physician and surgeon compensation from hospitals and networks. To increase orthopaedic surgery resident understanding of the unique needs of older adults in order to maintain effective and sensitive communication with this vulnerable population. A two-part training program (ongoing for 8 years) comprised of: 1) small-group interactive didactic sessions on aging issues; and 2) workshop demonstrations given by the residents to a group of older adults, followed by a Question & Answer session. Residents were assessed using a 22-item pre-post questionnaire covering medical knowledge of aging, attitudes toward older adults, and personal anxiety about aging. Older adult participants were surveyed for perceptions of residents' sensitivity toward them. Hospital for Special Surgery in New York City, a specialized urban academic center, with a 5-year Orthopedic Surgery Residency program. 70 PGY3 residents, for whom the program is a requirement, and 711 older adult participants recruited from a community convenience sample. Older adult participants: Of 711 participants, 672 (95%) responded; 96% strongly agreed/agreed that the residents had demonstrated sensitivity toward them. Residents: Of 70 residents, 35 (50%) were assessed. Mean knowledge scores increased significantly (p ≤ 0.001); five of nine attitude items (p ≤ 0.05) and one of four anxiety items improved significantly (p ≤ 0.001). Significant change was seen in residents' attitudes and anxiety levels toward older adults, attributes that are usually deep seated and hard to change. Residents moved along the Accreditation Council for Graduate

  15. 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

  16. 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.

  17. 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.

  18. Training in Basic Laparoscopic Surgical Skills : Residents Opinion of the New Nintendo Wii-U Laparoscopic Simulator

    NARCIS (Netherlands)

    Overtoom, Evelien M.; Jansen, Frank-Willem; van Santbrink, Evert J P; Schraffordt Koops, Steven E; Veersema, Sebastiaan; Schreuder, Henk W R

    2017-01-01

    Objective Serious games are new in the field of laparoscopic surgical training. We evaluate the residents׳ opinion of a new laparoscopic simulator for the Nintendo Wii-U platform. Design Prospective questionnaire study. Participants received a standardized introduction and completed level 3 and 4 of

  19. European consensus on a competency-based virtual reality training program for basic endoscopic surgical psychomotor skills.

    Science.gov (United States)

    van Dongen, Koen W; Ahlberg, Gunnar; Bonavina, Luigi; Carter, Fiona J; Grantcharov, Teodor P; Hyltander, Anders; Schijven, Marlies P; Stefani, Alessandro; van der Zee, David C; Broeders, Ivo A M J

    2011-01-01

    Virtual reality (VR) simulators have been demonstrated to improve basic psychomotor skills in endoscopic surgery. The exercise configuration settings used for validation in studies published so far are default settings or are based on the personal choice of the tutors. The purpose of this study was to establish consensus on exercise configurations and on a validated training program for a virtual reality simulator, based on the experience of international experts to set criterion levels to construct a proficiency-based training program. A consensus meeting was held with eight European teams, all extensively experienced in using the VR simulator. Construct validity of the training program was tested by 20 experts and 60 novices. The data were analyzed by using the t test for equality of means. Consensus was achieved on training designs, exercise configuration, and examination. Almost all exercises (7/8) showed construct validity. In total, 50 of 94 parameters (53%) showed significant difference. A European, multicenter, validated, training program was constructed according to the general consensus of a large international team with extended experience in virtual reality simulation. Therefore, a proficiency-based training program can be offered to training centers that use this simulator for training in basic psychomotor skills in endoscopic surgery.

  20. Simulation-based end-of-life care training during surgical clerkship: assessment of skills and perceptions.

    Science.gov (United States)

    Parikh, Priti P; Brown, Ronald; White, Mary; Markert, Ronald J; Eustace, Rosemary; Tchorz, Kathryn

    2015-06-15

    Assessment of interpersonal and psychosocial competencies during end-of-life care training is essential. This study reports the relationship between simulation-based end-of-life care Objective Structured Clinical Examination ratings and communication skills, trust, and self-assessed empathy along with the perceptions of students regarding their training experiences. Medical students underwent simulation-based end-of-life care OSCE training that involved standardized patients who evaluated students' communication skills and physician trust with the Kalamazoo Essential Elements Communication Checklist and the Wake Forest Physician Trust Scale. Students also completed the Jefferson Scale of Physician Empathy. Pearson correlation was used to examine the relationship between OSCE performance grades and communication, trust, and empathy scores. Student comments were analyzed using the constant comparative method of analysis to identify dominant themes. The 389 students (mean age 26.6 ± 2.8 y; 54.5% female) had OSCE grades that were positively correlated with physician trust scores (r = 0.325, P training to be a valuable learning experience and appreciated its placement early in clinical training. We found that simulation-based OSCE training in palliative and end-of-life care can be effectively conducted during a surgery clerkship. Moreover, the standardized patient encounters combined with the formal assessment of communication skills, physician trust, and empathy provide feedback to students at an early phase of their professional life. The positive and appreciative comments of students regarding the opportunity to practice difficult patient conversations suggest that attention to these professional characteristics and skills is a valued element of clinical training and conceivably a step toward better patient outcomes and satisfaction. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. 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.

  2. 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...

  3. 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...

  4. Robotic surgical training.

    Science.gov (United States)

    Ben-Or, Sharon; Nifong, L Wiley; Chitwood, W Randolph

    2013-01-01

    In July 2000, the da Vinci Surgical System (Intuitive Surgical, Inc) received Food and Drug Administration approval for intracardiac applications, and the first mitral valve repair was done at the East Carolina Heart Institute in May 2000. The system is now approved and used in many surgical specialties. With this disruptive technology and accepted use, surgeons and hospitals are seeking the most efficacious training pathway leading to safe use and responsible credentialing.One of the most important issues related to safe use is assembling the appropriate team of professionals involved with patient care. Moreover, proper patient selection and setting obtainable goals are also important.Creation and maintenance of a successful program are discussed in the article focusing on realistic goals. This begins with a partnership between surgeon leaders, hospital administrators, and industry support. Through this partnership, an appropriate training pathway and clinical pathway for success can be outlined. A timeline can then be created with periods of data analysis and adjustments as necessary. A successful program is attainable by following this pathway and attending to every detail along the journey.

  5. Communication skills training in surgical residency: a needs assessment and metacognition analysis of a difficult conversation objective structured clinical examination.

    Science.gov (United States)

    Falcone, John L; Claxton, René N; Marshall, Gary T

    2014-01-01

    The objective structured clinical examination (OSCE) can be used to evaluate the Accreditation Council for Graduate Medical Education Core Competencies of Professionalism and Interpersonal and Communication Skills. The aim of this study was to describe general surgery resident performance on a "difficult conversation" OSCE. In this prospective study, junior and senior residents participated in a 2-station OSCE. Junior stations involved discussing operative risks and benefits and breaking bad news. Senior stations involved discussing goals of care and discussing transition to comfort measures only status. Residents completed post-OSCE checklist and Likert-based self-evaluations of experience, comfort, and confidence. Trained standardized patients (SPs) evaluated residents using communication skill-based checklists and Likert-based assessments. Pearson correlation coefficients were determined between self-assessment and SP assessment. Mann-Whitney U tests were conducted between junior and senior resident variables, using α = 0.05. There were 27 junior residents (age 28.1 ± 1.9 years [29.6% female]) and 27 senior residents (age 32.1 ± 2.5 years [26.9% female]). The correlation of self-assessment and SP assessment of overall communication skills by junior residents was -0.32 on the risks and benefits case and 0.07 on the breaking bad news case. The correlation of self-assessment and SP assessment of overall communication skills by senior residents was 0.30 on the goals of care case and 0.26 on the comfort measures only case. SP assessments showed that junior residents had higher overall communication skills than senior residents (p = 0.03). Senior residents perceived that having difficult conversations was more level appropriate (p skills are correlated, and that skills-based training is needed across all residency levels. This well-received method may be used to observe, document, and provide resident feedback for these important skills. © 2014 Published by

  6. Team skills training

    International Nuclear Information System (INIS)

    Coe, R.P.; Carl, D.R.

    1991-01-01

    Numerous reports and articles have been written recently on the importance of team skills training for nuclear reactor operators, but little has appeared on the practical application of this theoretical guidance. This paper describes the activities of the Training and Education Department at GPU Nuclear (GPUN). In 1987, GPUN undertook a significant initiative in its licensed operator training programs to design and develop initial and requalification team skills training. Prior to that time, human interaction skills training (communication, stress management, supervisory skills, etc.) focused more on the individual rather than a group. Today, GPU Nuclear conducts team training at both its Three Mile Island (YMI), PA and Oyster Creek (OC), NJ generating stations. Videotaped feedback is sued extensively to critique and reinforce targeted behaviors. In fact, the TMI simulator trainer has a built-in, four camera system specifically designed for team training. Evaluations conducted on this training indicated these newly acquired skills are being carried over to the work environment. Team training is now an important and on-going part of GPUN operator training

  7. Training in Basic Laparoscopic Surgical Skills: Residents Opinion of the New Nintendo Wii-U Laparoscopic Simulator.

    Science.gov (United States)

    Overtoom, Evelien M; Jansen, Frank-Willem; van Santbrink, Evert J P; Schraffordt Koops, Steven E; Veersema, Sebastiaan; Schreuder, Henk W R

    Serious games are new in the field of laparoscopic surgical training. We evaluate the residents׳ opinion of a new laparoscopic simulator for the Nintendo Wii-U platform. Prospective questionnaire study. Participants received a standardized introduction and completed level 3 and 4 of the game "Underground." They filled out a questionnaire concerning demographics and their opinion on realism, usefulness, suitability, haptic feedback, and home training-use of the game. Two tertiary teaching hospitals. Obstetrics and gynaecology residents postgraduate year 1 to 6 (n = 59) from several European countries. Subjects (n = 59) were divided into 2 groups based on laparoscopic experience: Group A (n = 38) and Group B (n = 21). The realism of different aspects of the game received mean scores around 3 on a 5-point Likert scale. The hand-eye coordination was regarded most useful for training with a mean of 3.92 (standard deviation 0.93) and the game was considered most suitable for residents in the first part of their postgraduate training with a mean of 3.73 (standard deviation 0.97). Both groups differed especially concerning their opinion of the usefulness of the game as a training tool. Most residents liked the new serious game for the Nintendo Wii-U. The usefulness and suitability as a laparoscopic training tool were rated at an acceptable to high level. However, the game does require improvements such as inclusion of a good scoring system before it can be integrated in resident training curricula. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  8. Single versus multimodality training basic laparoscopic skills

    NARCIS (Netherlands)

    Brinkman, W.M.; Havermans, S.Y.; Buzink, S.N.; Botden, S.M.B.I.; Jakimowicz, J.J.; Schoot, B.C.

    2012-01-01

    Introduction - Even though literature provides compelling evidence of the value of simulators for training of basic laparoscopic skills, the best way to incorporate them into a surgical curriculum is unclear. This study compares the training outcome of single modality training with multimodality

  9. 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.

  10. 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.

  11. Otologic Skills Training

    DEFF Research Database (Denmark)

    Wiet, Gregory J; Sørensen, Mads Sølvsten; Andersen, Steven Arild Wuyts

    2017-01-01

    This article presents a summary of the current simulation training for otologic skills. There is a wide variety of educational approaches, assessment tools, and simulators in use, including simple low-cost task trainers to complex computer-based virtual reality systems. A systematic approach...

  12. A new virtual-reality training module for laparoscopic surgical skills and equipment handling: can multitasking be trained? A randomized controlled trial.

    Science.gov (United States)

    Bongers, Pim J; Diederick van Hove, P; Stassen, Laurents P S; Dankelman, Jenny; Schreuder, Henk W R

    2015-01-01

    During laparoscopic surgery distractions often occur and multitasking between surgery and other tasks, such as technical equipment handling, is a necessary competence. In psychological research, reduction of adverse effects of distraction is demonstrated when specifically multitasking is trained. The aim of this study was to examine whether multitasking and more specifically task-switching can be trained in a virtual-reality (VR) laparoscopic skills simulator. After randomization, the control group trained separately with an insufflator simulation module and a laparoscopic skills exercise module on a VR simulator. In the intervention group, insufflator module and VR skills exercises were combined to develop a new integrated training in which multitasking was a required competence. At random moments, problems with the insufflator appeared and forced the trainee to multitask. During several repetitions of a different multitask VR skills exercise as posttest, performance parameters (laparoscopy time, insufflator time, and errors) were measured and compared between both the groups as well with a pretest exercise to establish the learning effect. A face-validity questionnaire was filled afterward. University Medical Centre Utrecht, The Netherlands. Medical and PhD students (n = 42) from University Medical Centre Utrecht, without previous experience in laparoscopic simulation, were randomly assigned to either intervention (n = 21) or control group (n = 21). All participants performed better in the posttest exercises without distraction of the insufflator compared with the exercises in which multitasking was necessary to solve the insufflator problems. After training, the intervention group was significantly quicker in solving the insufflator problems (mean = 1.60Log(s) vs 1.70Log(s), p = 0.02). No significant differences between both the groups were seen in laparoscopy time and errors. Multitasking has negative effects on the laparoscopic performance. This study suggests

  13. Peer-assisted teaching of basic surgical skills.

    Science.gov (United States)

    Preece, Ryan; Dickinson, Emily Clare; Sherif, Mohamed; Ibrahim, Yousef; Ninan, Ann Susan; Aildasani, Laxmi; Ahmed, Sartaj; Smith, Philip

    2015-01-01

    Basic surgical skills training is rarely emphasised in undergraduate medical curricula. However, the provision of skills tutorials requires significant commitment from time-constrained surgical faculty. We aimed to determine how a peer-assisted suturing workshop could enhance surgical skills competency among medical students and enthuse them towards a career in surgery. Senior student tutors delivered two suturing workshops to second- and third- year medical students. Suturing performance was assessed before and after teaching in a 10-min suturing exercise (variables measured included number of sutures completed, suture tension, and inter-suture distance). Following the workshop, students completed a questionnaire assessing the effect of the workshop on their suturing technique and their intention to pursue a surgical career. Thirty-five students attended. Eighty-one percent believed their medical school course provided insufficient basic surgical skills training. The mean number of sutures completed post-teaching increased significantly (p teaching, to ± 2.6 mm post-teaching. All students found the teaching environment to be relaxed, and all felt the workshop helped to improve their suturing technique and confidence; 87% found the peer-taught workshop had increased their desire to undertake a career in surgery. Peer-assisted learning suturing workshops can enhance medical students' competence with surgical skills and inspire them towards a career in surgery. With very little staff faculty contribution, it is a cheap and sustainable way to ensure ongoing undergraduate surgical skills exposure.

  14. 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

  15. Human Emotion and Response in Surgery (HEARS): a simulation-based curriculum for communication skills, systems-based practice, and professionalism in surgical residency training.

    Science.gov (United States)

    Larkin, Anne C; Cahan, Mitchell A; Whalen, Giles; Hatem, David; Starr, Susan; Haley, Heather-Lyn; Litwin, Demetrius; Sullivan, Kate; Quirk, Mark

    2010-08-01

    This study examines the development and implementation of a pilot human factors curriculum during a 2-year period. It is one component of a comprehensive 5-year human factors curriculum spanning core competencies of interpersonal and communication skills, systems-based practice, and professionalism and using low-and high-fidelity simulation techniques. Members of the Department of Surgery and the Center for Clinical Communication and Performance Outcomes jointly constructed a curriculum for PGY1 and PGY2 residents on topics ranging from challenging communication to time and stress management. Video demonstrations, triggers, and simulated scenarios involving acting patients were created by surgeons and medical educators. Pre- and postintervention measures were obtained for communication skills, perceived stress level, and teamwork. Communication skills were evaluated using a series of video vignettes. The validated Perceived Stress Scale and Teamwork and Patient Safety Attitudes survey were used. Residents' perceptions of the program were also measured. Twenty-seven PGY1 residents and 15 PGY2 residents participated during 2 years. Analyses of video vignette tests indicated significant improvement in empathic communication for PGY1 (t = 3.62, p = 0.001) and PGY2 (t = 5.00, p = 0.004). There were no significant changes to teamwork attitudes. Perceived levels of stress became considerably higher. PGY1 residents reported trying 1 to 3 strategies taught in the time management session, with 60% to 75% reporting improvement post-training. This unique and comprehensive human factors curriculum is shown to be effective in building communication competency for junior-level residents in the human and emotional aspects of surgical training and practice. Continued refinement and ongoing data acquisition and analyses are underway. Copyright 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Instituting a Surgical Skills Competition Increases Technical Performance of Surgical Clerkship Students Over Time.

    Science.gov (United States)

    Leraas, Harold J; Cox, Morgan L; Bendersky, Victoria A; Sprinkle, Shanna S; Gilmore, Brian F; Gunasingha, Rathnayaka M; Tracy, Elisabeth T; Sudan, Ranjan

    2017-10-04

    Surgical skills training varies greatly between institutions and is often left to students to approach independently. Although many studies have examined single interventions of skills training, no data currently exists about the implementation of surgical skills assessment as a component of the medical student surgical curriculum. We created a technical skills competition and evaluated its effect on student surgical skill development. Second-year medical students enrolled in the surgery clerkship voluntarily participated in a surgical skills competition consisting of knot tying, laparoscopic peg transfer, and laparoscopic pattern cut. Winning students were awarded dinner with the chair of surgery and a resident of their choice. Individual event times and combined times were recorded and compared for students who completed without disqualification. Disqualification included compromising cutting pattern, dropping a peg out of the field of vision, and incorrect knot tying technique. Timed performance was compared for 2 subsequent academic years using Mann-Whitney U test. Overall, 175 students competed and 71 students met qualification criteria. When compared by academic year, 2015 to 2016 students (n = 34) performed better than 2014 to 2015 students (n = 37) in pattern cut (133s vs 167s, p = 0.040), peg transfer (66s vs 101s, p skills competition improves student technical performance. Further research is needed regarding long-term benefits of surgical competitions for medical students. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  17. Surgical training in the Netherlands

    NARCIS (Netherlands)

    Borel-Rinkes, Inne H. M.; Gouma, Dirk J.; Hamming, Jaap F.

    2008-01-01

    Surgical training in the Netherlands has traditionally been characterized by learning on the job under the classic master-trainee doctrine. Over the past decades, it has become regionally organized with intensive structural training courses, and a peer-based quality control system. Recently, the

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

    OpenAIRE

    Forgione, Antonello; Guraya, Salman Y.

    2017-01-01

    Background: 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. Th...

  19. 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.

  20. European consensus on a competency-based virtual reality training program for basic endoscopic surgical psychomotor skills

    NARCIS (Netherlands)

    van Dongen, Koen W.; Ahlberg, Gunnar; Bonavina, Luigi; Carter, Fiona J.; Grantcharov, Teodor P.; Hyltander, Anders; Schijven, Marlies P.; Stefani, Alessandro; van der Zee, David C.; Broeders, Ivo A. M. J.

    2011-01-01

    Virtual reality (VR) simulators have been demonstrated to improve basic psychomotor skills in endoscopic surgery. The exercise configuration settings used for validation in studies published so far are default settings or are based on the personal choice of the tutors. The purpose of this study was

  1. European consensus on a competency-based virtual reality training program for basic endoscopic surgical psychomotor skills

    NARCIS (Netherlands)

    van Dongen, Koen W.; Ahlberg, Gunnar; Bonavina, Luigi; Carter, Fiona J.; Grantcharov, Teodor P.; Hyltander, Anders; Schijven, Marlies P.; Stefani, Alessandro; van der Zee, David C.; Broeders, Ivo A. M. J.

    Virtual reality (VR) simulators have been demonstrated to improve basic psychomotor skills in endoscopic surgery. The exercise configuration settings used for validation in studies published so far are default settings or are based on the personal choice of the tutors. The purpose of this study was

  2. 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...

  3. Excised Abdominoplasty Material as a Systematic Plastic Surgical Training Model

    Directory of Open Access Journals (Sweden)

    M. Erol Demirseren

    2012-01-01

    Full Text Available Achieving a level of technical skill and confidence in surgical operations is the main goal of plastic surgical training. Operating rooms were accepted as the practical teaching venues of the traditional apprenticeship model. However, increased patient population, time, and ethical and legal considerations made preoperation room practical work a must for plastic surgical training. There are several plastic surgical teaching models and simulators which are very useful in preoperation room practical training and the evaluation of plastic surgery residents. The full thickness skin with its vascular network excised in abdominoplasty procedures is an easily obtainable real human tissue which could be used as a training model in plastic surgery.

  4. 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.

  5. Advanced surgical skills for exposure in trauma: a new surgical skills cadaver course for surgery residents and fellows.

    Science.gov (United States)

    Kuhls, Deborah A; Risucci, Donald A; Bowyer, Mark W; Luchette, Fred A

    2013-02-01

    Surgical education is changing owing to workforce and economic demands. Simulation and other technical teaching methods are used to acquire skills transferable to the operating room. Operative management of traumatic injuries has declined, making it difficult to acquire and maintain competence. The ASSET course was developed by the Committee on Trauma's Surgical Skills Committee to fill a surgical skills need in resident and fellow education. Using a human cadaver, standardized rapid exposure of vital structures in the extremities, neck, thorax, abdomen, retroperitoneum, and pelvis is taught. A retrospective analysis of 79 participants in four ASSET courses was performed. Operative experience data were collected, and self-efficacy questionnaires (SEQs) were administered before and after the course. Course evaluations and instructor evaluation data were analyzed. Student's and paired samples t tests as well as analysis of variance and Spearman ρ correlation coefficient analysis were performed using α at p ASSET course would teach new surgical techniques and that learner self-assessed ability would improve. Participants included 27 PGY-4, 20 PGY-5, 24 PGY-6 or PGY-7 and PGY-8 at other levels of training. Self-assessed confidence improved in all body regions (p knowledge rated at 4.8 and learning new techniques at 4.72. A standardized cadaver-based surgical exposures course offered to senior surgical residents adds new surgical skills and improves participant self-assessed ability to perform emergent surgical exposure of vital structures.

  6. 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

  7. The impact of goal setting and goal orientation on performance during a clerkship surgical skills training program.

    Science.gov (United States)

    Gardner, Aimee K; Diesen, Diana L; Hogg, Deborah; Huerta, Sergio

    2016-02-01

    The purpose of this study was to integrate relevant goal-setting theory and to identify if trainees' goal orientations have an impact on the assigned goals-performance relationship. Trainees attended 1 of the 3 goal-training activities (do your best, performance, or learning goals) for knot tying (KT) and camera navigation (CN) during the 3rd-year clerkship rotation. Questionnaires and pretests and/or post-tests were completed. One twenty-seven 3rd-year medical students (age: 25 ± 2.6; 54% women) participated in the training program. Pretraining to post-training performance changes were significant for all groups on both tasks (P goals group (do your best: KTΔ = 2.14, CNΔ = 1.69; performance: KTΔ = 2.49, CNΔ = 2.24; learning: KTΔ = 3.04 CNΔ = 2.76). Correlations between goal orientations and improvement were examined, revealing a unique role of goal orientation for performance improvement. These data indicate that consideration of goal type and trainee goal orientation must be considered during curriculum development to maximize educational value. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Training Adaptability in Digital Skills

    National Research Council Canada - National Science Library

    Hess-Kosa, Kathleen

    2001-01-01

    .... As outlined in this Phase I report, Aptima and the Group for Organizational Effectiveness (gOE) have lain the groundwork for an innovative, computer-based, digital-skills training package designed to increase the adaptability of digital skills...

  9. 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.

  10. 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.

  11. Communication skills in psychiatry training.

    Science.gov (United States)

    Ditton-Phare, Philippa; Halpin, Sean; Sandhu, Harsimrat; Kelly, Brian; Vamos, Marina; Outram, Sue; Bylund, Carma L; Levin, Tomer; Kissane, David; Cohen, Martin; Loughland, Carmel

    2015-08-01

    Mental health clinicians can experience problems communicating distressing diagnostic information to patients and their families, especially about severe mental illnesses such as schizophrenia. Evidence suggests that interpersonal communication skills can be effectively taught, as has been demonstrated in the specialty of oncology. However, very little literature exists with respect to interpersonal communication skills training for psychiatry. This paper provides an overview of the communication skills training literature. The report reveals significant gaps exist and highlights the need for advanced communication skills training for mental health clinicians, particularly about communicating a diagnosis and/or prognosis of schizophrenia. A new communication skills training framework for psychiatry is described, based on that used in oncology as a model. This model promotes applied skills and processes that are easily adapted for use in psychiatry, providing an effective platform for the development of similar training programs for psychiatric clinical practice. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  12. 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...

  13. EVA Skills Training

    Science.gov (United States)

    Parazynski, Scott

    2012-01-01

    Dr. Parazynski and a colleague from Extravehicular Activity (EVA), Robotics, & Crew Systems Operations (DX) worked closely to build the EVA Skills Training Program, and for the first time, defined the gold standards of EVA performance, allowing crewmembers to increase their performance significantly. As part of the program, individuals had the opportunity to learn at their own rate, taking additional water time as required, to achieve that level of performance. This focus on training to one's strengths and weaknesses to bolster them enabled the Crew Office and DX to field a much larger group of spacewalkers for the daunting "wall of EVA" required for the building and maintenance of the ISS. Parazynski also stressed the need for designers to understand the capabilities and the limitations of a human in a spacesuit, as well as opportunities to improve future generations of space. He shared lessons learned (how the Crew Office engaged in these endeavors) and illustrated the need to work as a team to develop these complex systems.

  14. 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.

  15. 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

  16. 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.

  17. Improving the Teaching Skills of Residents in a Surgical Training Program: Results of the Pilot Year of a Curricular Initiative in an Ophthalmology Residency Program.

    Science.gov (United States)

    Chee, Yewlin E; Newman, Lori R; Loewenstein, John I; Kloek, Carolyn E

    2015-01-01

    To design and implement a teaching skills curriculum that addressed the needs of an ophthalmology residency training program, to assess the effect of the curriculum, and to present important lessons learned. A teaching skills curriculum was designed for the Harvard Medical School (HMS) Residency Training Program in Ophthalmology. Results of a needs assessment survey were used to guide curriculum objectives. Overall, 3 teaching workshops were conducted between October 2012 and March 2013 that addressed areas of need, including procedural teaching. A postcurriculum survey was used to assess the effect of the curriculum. Massachusetts Eye and Ear Infirmary, a tertiary care institution in Boston, MA. Overall, 24 residents in the HMS Residency Training Program in Ophthalmology were included. The needs assessment survey demonstrated that although most residents anticipated that teaching would be important in their future career, only one-third had prior formal training in teaching. All residents reported they found the teaching workshops to be either very or extremely useful. All residents reported they would like further training in teaching, with most residents requesting additional training in best procedural teaching practices for future sessions. The pilot year of the resident-as-teacher curriculum for the HMS Residency Training Program in Ophthalmology demonstrated a need for this curriculum and was perceived as beneficial by the residents, who reported increased comfort in their teaching skills after attending the workshops. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  18. 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.

  19. 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.

  20. 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

  1. The Pareto Analysis for Establishing Content Criteria in Surgical Training

    NARCIS (Netherlands)

    Kramp, Kelvin H.; van Det, Marc J.; Veeger, Nic J. G. M.; Pierie, Jean-Pierre E. N.

    2016-01-01

    INTRODUCTION: Current surgical training is still highly dependent on expensive operating room (OR) experience. Although there have been many attempts to transfer more training to the skills laboratory, little research is focused on which technical behaviors can lead to the highest profit when they

  2. 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...

  3. 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.

  4. Effective and efficient learning in the operating theater with intraoperative video-enhanced surgical procedure training

    NARCIS (Netherlands)

    van Det, M.J.; Meijerink, W.J.; Hoff, C.; Middel, B.; Pierie, J.P.

    INtraoperative Video Enhanced Surgical procedure Training (INVEST) is a new training method designed to improve the transition from basic skills training in a skills lab to procedural training in the operating theater. Traditionally, the master-apprentice model (MAM) is used for procedural training

  5. The effect of implementing cognitive load theory-based design principles in virtual reality simulation training of surgical skills: a randomized controlled trial

    DEFF Research Database (Denmark)

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

    2016-01-01

    training of mastoidectomy. Methods Eighteen novice medical students received 1 h of self-directed virtual reality simulation training of the mastoidectomy procedure randomized for standard instructions (control) or cognitive load theory-based instructions with a worked example followed by a problem......Background Cognitive overload can inhibit learning, and cognitive load theory-based instructional design principles can be used to optimize learning situations. This study aims to investigate the effect of implementing cognitive load theory-based design principles in virtual reality simulation....... Increased cognitive load when part tasks needed to be integrated in the post-training procedures could be a possible explanation for this. Other instructional designs and methods are needed to lower the cognitive load and improve the performance in virtual reality surgical simulation training of novices....

  6. 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.

  7. Metrics for Objective Assessment of Surgical Skills Workshop

    National Research Council Canada - National Science Library

    Satava, Richard

    2001-01-01

    On 9-10 July, 2001 the Metrics for Objective Assessment of Surgical Skills Workshop convened an international assemblage of subject matter experts in objective assessment of surgical technical skills...

  8. The effect of implementing cognitive load theory-based design principles in virtual reality simulation training of surgical skills: a randomized controlled trial.

    Science.gov (United States)

    Andersen, Steven Arild Wuyts; Mikkelsen, Peter Trier; Konge, Lars; Cayé-Thomasen, Per; Sørensen, Mads Sølvsten

    2016-01-01

    Cognitive overload can inhibit learning, and cognitive load theory-based instructional design principles can be used to optimize learning situations. This study aims to investigate the effect of implementing cognitive load theory-based design principles in virtual reality simulation training of mastoidectomy. Eighteen novice medical students received 1 h of self-directed virtual reality simulation training of the mastoidectomy procedure randomized for standard instructions (control) or cognitive load theory-based instructions with a worked example followed by a problem completion exercise (intervention). Participants then completed two post-training virtual procedures for assessment and comparison. Cognitive load during the post-training procedures was estimated by reaction time testing on an integrated secondary task. Final-product analysis by two blinded expert raters was used to assess the virtual mastoidectomy performances. Participants in the intervention group had a significantly increased cognitive load during the post-training procedures compared with the control group (52 vs. 41 %, p  = 0.02). This was also reflected in the final-product performance: the intervention group had a significantly lower final-product score than the control group (13.0 vs. 15.4, p  virtual reality surgical simulation training of novices.

  9. 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.

  10. Communication training: Skills and beyond.

    Science.gov (United States)

    Deveugele, Myriam

    2015-10-01

    As communication is a central part of every interpersonal meeting within healthcare and research reveals several benefits of effective communication, we need to teach students and practitioners how to communicate with patients and with colleagues. This paper reflects on what and how to teach. In the previous century two major changes occurred: clinical relationship between doctor and patient became important and patients became partners in care. Clinicians experienced that outcome and especially compliance was influenced by the relational aspect and in particular by the communicative skills of the physician. This paper reflects on teaching and defines problems. It gives some implications for the future. Although communication skills training is reinforced in most curricula all over the word, huge implementation problems arise; most of the time a coherent framework is lacking, training is limited in time, not integrated in the curriculum and scarcely contextualized, often no formal training nor teaching strategies are defined. Moreover evidence on communication skills training is scarce or contradictory. Knowing when, what, how can be seen as an essential part of skills training. But students need to be taught to reflect on every behavior during every medical consultation. Three major implications can be helpful to overcome the problems in communication training. First research and education on healthcare issues need to go hand in hand. Second, students as well as healthcare professionals need a toolkit of basic skills to give them the opportunity not only to tackle basic and serious problems, but to incorporate these skills and to be able to use them in a personal and creative way. Third, personal reflection on own communicative actions and dealing with interdisciplinary topics is a core business of medical communication and training. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Crowd-sourced assessment of surgical skills in cricothyrotomy procedure.

    Science.gov (United States)

    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.

  12. Serious gaming and voluntary laparoscopic skills training : A multicenter study

    NARCIS (Netherlands)

    Verdaasdonk, E.; Dankelman, J.; Schijven, M.P.; Lange, J.F.; Wentink, M.; Stassen, L.P.S.

    2009-01-01

    This study assesses the issue of voluntary training of a standardized online competition (serious gaming) between surgical residents. Surgical residents were invited to join a competition on a virtual reality (VR) simulator for laparoscopic motor skills. A final score was calculated based on the

  13. Serious gaming and voluntary laparoscopic skills training: a multicenter study

    NARCIS (Netherlands)

    Verdaasdonk, E. G. G.; Dankelman, J.; Schijven, M. P.; Lange, J. F.; Wentink, M.; Stassen, L. P. S.

    2009-01-01

    This study assesses the issue of voluntary training of a standardized online competition (serious gaming) between surgical residents. Surgical residents were invited to join a competition on a virtual reality (VR) simulator for laparoscopic motor skills. A final score was calculated based on the

  14. Virtual reality in surgical training.

    Science.gov (United States)

    Lange, T; Indelicato, D J; Rosen, J M

    2000-01-01

    Virtual reality in surgery and, more specifically, in surgical training, faces a number of challenges in the future. These challenges are building realistic models of the human body, creating interface tools to view, hear, touch, feel, and manipulate these human body models, and integrating virtual reality systems into medical education and treatment. A final system would encompass simulators specifically for surgery, performance machines, telemedicine, and telesurgery. Each of these areas will need significant improvement for virtual reality to impact medicine successfully in the next century. This article gives an overview of, and the challenges faced by, current systems in the fast-changing field of virtual reality technology, and provides a set of specific milestones for a truly realistic virtual human body.

  15. 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.

  16. Communication skills training in orthopaedics.

    Science.gov (United States)

    Lundine, Kristopher; Buckley, Richard; Hutchison, Carol; Lockyer, Jocelyn

    2008-06-01

    Communication skills play a key role in many aspects of both medical education and clinical patient care. The objectives of this study were to identify the key components of communication skills from the perspectives of both orthopaedic residents and their program directors and to understand how these skills are currently taught. This study utilized a mixed methods design. Quantitative data were collected with use of a thirty-item questionnaire distributed to all Canadian orthopaedic residents. Qualitative data were collected through focus groups with orthopaedic residents and semistructured interviews with orthopaedic program directors. One hundred and nineteen (37%) of 325 questionnaires were completed, twelve residents participated in two focus groups, and nine of sixteen program directors from across the country were interviewed. Both program directors and residents identified communication skills as being the accurate and appropriate use of language (i.e., content skills), not how the communication was presented (i.e., process skills). Perceived barriers to effective communication included time constraints and the need to adapt to the many personalities and types of people encountered daily in the hospital. Residents rarely have explicit training in communication skills. They rely on communication training implicitly taught through observation of their preceptors and clinical experience interacting with patients, peers, and other health-care professionals. Orthopaedic residents and program directors focus on content and flexibility within communication skills as well as on the importance of being concise. They value the development of communication skills in the clinical environment through experiential learning and role modeling. Education should focus on developing residents' process skills in communication. Care should be taken to avoid large-group didactic teaching sessions, which are perceived as ineffective.

  17. Communications skills for CRM training

    Science.gov (United States)

    Shearer, M.

    1984-01-01

    A pilot training program in communication skills, listening, conflict solving, and task orientation, for a small but growing commuter airline is discussed. The interactions between pilots and management, and communication among crew members are examined. Methods for improvement of cockpit behavior management personnel relations are investigated.

  18. 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.

  19. 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.

  20. Mental skills training in soccer

    DEFF Research Database (Denmark)

    Diment, Gregory Michael

    2014-01-01

    Psychological Skills Training (PST) has been a tool used by sport psychology consultants. However, within soccer many of these programs have been delivered as workshops, homework tasks, or individual consultations with athletes. The aim of the project was to develop an ecological intervention...... by creating a series of drillbased sessions to train psychological skills, and educate coaches about how to implement and integrate PST as a natural part of daily training. The program was delivered to the youth academies in nine Danish professional soccer clubs and consisted of three phases: (a) planning...... of the program, (b) education and designing soccer drills, and (c) delivery of the drills on the soccer pitch. The program was well received by clubs, coaches, and players. With regards to project aims, the intervention was generally considered a success. Coaches reported that the drill-based nature...

  1. Assessment of technical and nontechnical skills in surgical residents.

    Science.gov (United States)

    Ponton-Carss, Alicia; Kortbeek, John B; Ma, Irene W Y

    2016-11-01

    Surgical competence encompasses both technical and nontechnical skills. This study seeks to evaluate the validity evidence for a comprehensive surgical skills examination and to examine the relationship between technical and nontechnical skills. Six examination stations assessing both technical and nontechnical skills, conducted yearly for surgical trainees (n = 120) between 2010 and 2014 are included. The assessment tools demonstrated acceptable internal consistency. Interstation reliability for technical skills was low (alpha = .39). Interstation reliability for the nontechnical skills was lower (alpha range -.05 to .31). Nontechnical skills domains were strongly correlated, ranging from r = .65, P skills were inconsistent, ranging from poor (r = -.06; P = .54) to moderate (r = .45; P skills are necessary to assess overall surgical competency. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Automated social skills training with audiovisual information.

    Science.gov (United States)

    Tanaka, Hiroki; Sakti, Sakriani; Neubig, Graham; Negoro, Hideki; Iwasaka, Hidemi; Nakamura, Satoshi

    2016-08-01

    People with social communication difficulties tend to have superior skills using computers, and as a result computer-based social skills training systems are flourishing. Social skills training, performed by human trainers, is a well-established method to obtain appropriate skills in social interaction. Previous works have attempted to automate one or several parts of social skills training through human-computer interaction. However, while previous work on simulating social skills training considered only acoustic and linguistic features, human social skills trainers take into account visual features (e.g. facial expression, posture). In this paper, we create and evaluate a social skills training system that closes this gap by considering audiovisual features regarding ratio of smiling, yaw, and pitch. An experimental evaluation measures the difference in effectiveness of social skill training when using audio features and audiovisual features. Results showed that the visual features were effective to improve users' social skills.

  3. 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.

  4. 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.

  5. 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.

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

    Directory of Open Access Journals (Sweden)

    Antonello Forgione

    2017-01-01

    Full Text Available Background: 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. Materials and Methods: 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. Results: 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

  7. 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.

  8. Effective and efficient learning in the operating theater with intraoperative video-enhanced surgical procedure training

    OpenAIRE

    van Det, M.J.; Meijerink, W.J.; Hoff, C.; Middel, B.; Pierie, J.P.

    2013-01-01

    INtraoperative Video Enhanced Surgical procedure Training (INVEST) is a new training method designed to improve the transition from basic skills training in a skills lab to procedural training in the operating theater. Traditionally, the master-apprentice model (MAM) is used for procedural training in the operating theater, but this model lacks uniformity and efficiency at the beginning of the learning curve. This study was designed to investigate the effectiveness and efficiency of INVEST co...

  9. 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.

  10. 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.

  11. Can a virtual reality surgical simulation training provide a self-driven and mentor-free skills learning? Investigation of the practical influence of the performance metrics from the virtual reality robotic surgery simulator on the skill learning and associated cognitive workloads.

    Science.gov (United States)

    Lee, Gyusung I; Lee, Mija R

    2018-01-01

    While it is often claimed that virtual reality (VR) training system can offer self-directed and mentor-free skill learning using the system's performance metrics (PM), no studies have yet provided evidence-based confirmation. This experimental study investigated what extent to which trainees achieved their self-learning with a current VR simulator and whether additional mentoring improved skill learning, skill transfer and cognitive workloads in robotic surgery simulation training. Thirty-two surgical trainees were randomly assigned to either the Control-Group (CG) or Experiment-Group (EG). While the CG participants reviewed the PM at their discretion, the EG participants had explanations about PM and instructions on how to improve scores. Each subject completed a 5-week training using four simulation tasks. Pre- and post-training data were collected using both a simulator and robot. Peri-training data were collected after each session. Skill learning, time spent on PM (TPM), and cognitive workloads were compared between groups. After the simulation training, CG showed substantially lower simulation task scores (82.9 ± 6.0) compared with EG (93.2 ± 4.8). Both groups demonstrated improved physical model tasks performance with the actual robot, but the EG had a greater improvement in two tasks. The EG exhibited lower global mental workload/distress, higher engagement, and a better understanding regarding using PM to improve performance. The EG's TPM was initially long but substantially shortened as the group became familiar with PM. Our study demonstrated that the current VR simulator offered limited self-skill learning and additional mentoring still played an important role in improving the robotic surgery simulation training.

  12. 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....

  13. Virtual reality simulation in endovascular surgical training.

    LENUS (Irish Health Repository)

    Tsang, J S

    2008-08-01

    Shortened trainingtimes duetothe European Working Time Directive (EWTD) and increased public scrutiny of surgical competency have led to a move away from the traditional apprenticeship model of training. Virtual reality (VR) simulation is a fascinating innovation allowing surgeons to develop without the need to practice on real patients and it may be a solution to achieve competency within a shortened training period.

  14. Laparoscopic skills acquisition: a study of simulation and traditional training.

    Science.gov (United States)

    Marlow, Nicholas; Altree, Meryl; Babidge, Wendy; Field, John; Hewett, Peter; Maddern, Guy J

    2014-12-01

    Training in basic laparoscopic skills can be undertaken using traditional methods, where trainees are educated by experienced surgeons through a process of graduated responsibility or by simulation-based training. This study aimed to assess whether simulation trained individuals reach the same level of proficiency in basic laparoscopic skills as traditional trained participants when assessed in a simulated environment. A prospective study was undertaken. Participants were allocated to one of two cohorts according to surgical experience. Participants from the inexperienced cohort were randomized to receive training in basic laparoscopic skills on either a box trainer or a virtual reality simulator. They were then assessed on the simulator on which they did not receive training. Participants from the experienced cohort, considered to have received traditional training in basic laparoscopic skills, did not receive simulation training and were randomized to either the box trainer or virtual reality simulator for skills assessment. The assessment scores from different cohorts on either simulator were then compared. A total of 138 participants completed the assessment session, 101 in the inexperienced simulation-trained cohort and 37 on the experienced traditionally trained cohort. There was no statistically significant difference between the training outcomes of simulation and traditionally trained participants, irrespective of the simulator type used. The results demonstrated that participants trained on either a box trainer or virtual reality simulator achieved a level of basic laparoscopic skills assessed in a simulated environment that was not significantly different from participants who had been traditionally trained in basic laparoscopic skills. © 2013 Royal Australasian College of Surgeons.

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

    Science.gov (United States)

    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.

  16. Parent-Implemented Behavioral Skills Training of Social Skills

    Science.gov (United States)

    Dogan, Rebecca K.; King, Melissa L.; Fischetti, Anthony T.; Lake, Candice M.; Mathews, Therese L.; Warzak, William J.

    2017-01-01

    Impairment in social skills is a primary feature of Autism Spectrum Disorders (ASDs). Research indicates that social skills are intimately tied to social development and negative social consequences can persist if specific social behaviors are not acquired. The present study evaluated the effects of behavioral skills training (BST) on teaching…

  17. 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.

  18. Training of Leadership Skills in Medical Education

    Science.gov (United States)

    Kiesewetter, Jan; Schmidt-Huber, Marion; Netzel, Janine; Krohn, Alexandra C.; Angstwurm, Matthias; Fischer, Martin R.

    2013-01-01

    Background: Effective team performance is essential in the delivery of high-quality health-care. Leadership skills therefore are an important part of physicians’ everyday clinical life. To date, the development of leadership skills are underrepresented in medical curricula. Appropriate training methods for equipping doctors with these leadership skills are highly desirable. Objective: The review aims to summarize the findings in the current literature regarding training in leadership skills in medicine and tries to integrate the findings to guide future research and training development. Method: The PubMED, ERIC, and PsycArticles, PsycINFO, PSYNDEX and Academic search complete of EBSCOhost were searched for training of leadership skills in medicine in German and English. Relevant articles were identified and findings were integrated and consolidated regarding the leadership principles, target group of training and number of participants, temporal resources of the training, training content and methods, the evaluation design and trainings effects. Results: Eight studies met all inclusion criteria and no exclusion criteria. The range of training programs is very broad and leadership skill components are diverse. Training designs implied theoretical reflections of leadership phenomena as well as discussions of case studies from practice. The duration of training ranged from several hours to years. Reactions of participants to trainings were positive, yet no behavioral changes through training were examined. Conclusions: More research is needed to understand the factors critical to success in the development of leadership skills in medical education and to adapt goal-oriented training methods. Requirements analysis might help to gain knowledge about the nature of leadership skills in medicine. The authors propose a stronger focus on behavioral training methods like simulation-based training for leadership skills in medical education. PMID:24282452

  19. Training of leadership skills in medical education.

    Science.gov (United States)

    Kiesewetter, Jan; Schmidt-Huber, Marion; Netzel, Janine; Krohn, Alexandra C; Angstwurm, Matthias; Fischer, Martin R

    2013-01-01

    Effective team performance is essential in the delivery of high-quality health-care. Leadership skills therefore are an important part of physicians' everyday clinical life. To date, the development of leadership skills are underrepresented in medical curricula. Appropriate training methods for equipping doctors with these leadership skills are highly desirable. The review aims to summarize the findings in the current literature regarding training in leadership skills in medicine and tries to integrate the findings to guide future research and training development. The PubMED, ERIC, and PsycArticles, PsycINFO, PSYNDEX and Academic search complete of EBSCOhost were searched for training of leadership skills in medicine in German and English. Relevant articles were identified and findings were integrated and consolidated regarding the leadership principles, target group of training and number of participants, temporal resources of the training, training content and methods, the evaluation design and trainings effects. Eight studies met all inclusion criteria and no exclusion criteria. The range of training programs is very broad and leadership skill components are diverse. Training designs implied theoretical reflections of leadership phenomena as well as discussions of case studies from practice. The duration of training ranged from several hours to years. Reactions of participants to trainings were positive, yet no behavioral changes through training were examined. More research is needed to understand the factors critical to success in the development of leadership skills in medical education and to adapt goal-oriented training methods. Requirements analysis might help to gain knowledge about the nature of leadership skills in medicine. The authors propose a stronger focus on behavioral training methods like simulation-based training for leadership skills in medical education.

  20. Applying Technology to Train Visualization Skills

    National Research Council Canada - National Science Library

    Nanda, Sanjeeb

    2005-01-01

    .... Training visualization skills, such as terrain appreciation, is generally difficult and inefficient in the real world with natural representations or in a classroom with analog representations...

  1. 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

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  5. Robot-assisted laparoscopic skills development: formal versus informal training.

    Science.gov (United States)

    Benson, Aaron D; Kramer, Brandan A; Boehler, Margaret; Schwind, Cathy J; Schwartz, Bradley F

    2010-08-01

    The learning curve for robotic surgery is not completely defined, and ideal training components have not yet been identified. We attempted to determine whether skill development would be accelerated with formal, organized instruction in robotic surgical techniques versus informal practice alone. Forty-three medical students naive to robotic surgery were randomized into two groups and tested on three tasks using the robotic platform. Between the testing sessions, the students were given equally timed practice sessions. The formal training group participated in an organized, formal training session with instruction from an attending robotic surgeon, whereas the informal training group participated in an equally timed unstructured practice session with the robot. The results were compared based on technical score and time to completion of each task. There was no difference between groups in prepractice testing for any task. In postpractice testing, there was no difference between groups for the ring transfer tasks. However, for the suture placement and knot-tying task, the technical score of the formal training group was significantly better than that of the informal training group (p formal training may not be necessary for basic skills, formal instruction for more advanced skills, such as suture placement and knot tying, is important in developing skills needed for effective robotic surgery. These findings may be important in formulating potential skills labs or training courses for robotic surgery.

  6. 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 ...

  7. Establishing Fire Safety Skills Using Behavioral Skills Training

    Science.gov (United States)

    Houvouras, Andrew J., IV; Harvey, Mark T.

    2014-01-01

    The use of behavioral skills training (BST) to educate 3 adolescent boys on the risks of lighters and fire setting was evaluated using in situ assessment in a school setting. Two participants had a history of fire setting. After training, all participants adhered to established rules: (a) avoid a deactivated lighter, (b) leave the training area,…

  8. 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.

  9. Undergraduate basic surgical skills education: impact on attitudes to a career in surgery and surgical skills acquisition.

    Science.gov (United States)

    McAnena, P F; O'Halloran, N; Moloney, B M; Courtney, D; Waldron, R M; Flaherty, G; Kerin, M J

    2018-05-01

    Basic surgical skills modules in medical education are effective in teaching skills and increasing confidence among students approaching surgery. However, these modules are not delivered universally and their effect on the professional development of graduates has not been established. We aimed to assess the impact of a 10-week basic surgical skills module on attitudes and technical skills of first year medical students compared to interns. Eighteen students participated and were assessed using a 4-part questionnaire. Technical skills were assessed by observing students perform a basic interrupted suture, using the objective structured assessment of technical skills (OSATS) tool. Fourteen interns were recruited. Students were more confident in surgical scrubbing (mean score 4.0 vs. 2.86, p = 0.001), and performing a basic suture (4.05 vs. 1.93, p = 0.000), more enthusiastic about assisting with an operation (4.5 vs. 3.0, p = 0.001) and more likely to consider a career in surgery (4.16 vs. 2.28, p = 0.000). Technical skills were greater in the student group (mean score 30.8 vs. 19.6, p = 0.001). Five interns had taken part in surgical skills modules as undergraduates. Their technical skills were significantly higher compared to interns who had not (n = 9) (28.8 vs. 14.5, p = 0.006), and they were more likely to consider a career in surgery (3.6 vs. 1.5, p = 0.036). The introduction of surgical skills teaching to the undergraduate medical curriculum has a positive impact on students' attitudes towards surgery and accelerates basic technical skills development. Consideration should be given to development of a standardised undergraduate core curriculum in basic surgical skills teaching.

  10. Application of Higher Diploma Program training skills

    African Journals Online (AJOL)

    RPO

    This article examines the application Higher Diploma training skills in classroom instruction as .... the intention of articulating the extent to which the ... graduates are applying HDP training skills ... HDP) to revisit their procedure, which result ..... not believe in the usefulness of the ... of this study perceived CPD as a program.

  11. Analysis and training of cognitive skills

    International Nuclear Information System (INIS)

    Mumaw, R.J.

    1991-01-01

    Cognitive skills (e.g., decision making, problem solving) are critical to many jobs in the nuclear power industry, and yet the standard approach to training development does not always train these skills most effectively. In most cases, these skills are not described in sufficient detail, and training programs fail to address them explicitly. Cognitive psychologists have developed a set of techniques, based on analysis of expertise, for describing cognitive skills in more detail. These techniques incorporate a diverse set of human performance measures. An example is given to illustrate a method for determining how experts represent problems mentally. Cognitive psychologists have also established a set of empirical findings concerning skill acquisition. These findings can be used to provide some general rules for structuring the training of cognitive skills

  12. 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

  13. 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

  14. The effect of implementing cognitive load theory-based design principles in virtual reality simulation training of surgical skills: a randomized controlled trial

    DEFF Research Database (Denmark)

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

    2016-01-01

    Cognitive overload can inhibit learning, and cognitive load theory-based instructional design principles can be used to optimize learning situations. This study aims to investigate the effect of implementing cognitive load theory-based design principles in virtual reality simulation training...

  15. The SimSpay-Student Perceptions of a Low-Cost Build-It-Yourself Model for Novice Training of Surgical Skills in Canine Ovariohysterectomy

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Toft, Nils; Eriksen, Thomas

    2015-01-01

    -type scale, students were asked to rate their perceived levels of competence, confidence, and anatomic knowledge before and after SimSpay training. Results demonstrate a strongly significant (p perceived levels...... of competence, confidence, and anatomic knowledge, the low-fidelity Sim Spay is a useful, low-cost learning tool for teaching ovariohysterectomy....

  16. Skills-O-Mat: Computer Supported Interactive Motion- and Game-Based Training in Mixing Alginate in Dental Education

    Science.gov (United States)

    Hannig, Andreas; Lemos, Martin; Spreckelsen, Cord; Ohnesorge-Radtke, Ulla; Rafai, Nicole

    2013-01-01

    The training of motor skills is a crucial aspect of medical education today. Serious games and haptic virtual simulations have been used in the training of surgical procedures. Otherwise, however, a combination of serious games and motor skills training is rarely used in medical education. This article presents Skills-O-Mat, an interactive serious…

  17. 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...

  18. Surgical simulation training in orthopedics: current insights.

    Science.gov (United States)

    Kalun, Portia; Wagner, Natalie; Yan, James; Nousiainen, Markku T; Sonnadara, Ranil R

    2018-01-01

    While the knowledge required of residents training in orthopedic surgery continues to increase, various factors, including reductions in work hours, have resulted in decreased clinical learning opportunities. Recent work suggests residents graduate from their training programs without sufficient exposure to key procedures. In response, simulation is increasingly being incorporated into training programs to supplement clinical learning. This paper reviews the literature to explore whether skills learned in simulation-based settings results in improved clinical performance in orthopedic surgery trainees. A scoping review of the literature was conducted to identify papers discussing simulation training in orthopedic surgery. We focused on exploring whether skills learned in simulation transferred effectively to a clinical setting. Experimental studies, systematic reviews, and narrative reviews were included. A total of 15 studies were included, with 11 review papers and four experimental studies. The review articles reported little evidence regarding the transfer of skills from simulation to the clinical setting, strong evidence that simulator models discriminate among different levels of experience, varied outcome measures among studies, and a need to define competent performance in both simulated and clinical settings. Furthermore, while three out of the four experimental studies demonstrated transfer between the simulated and clinical environments, methodological study design issues were identified. Our review identifies weak evidence as to whether skills learned in simulation transfer effectively to clinical practice for orthopedic surgery trainees. Given the increased reliance on simulation, there is an immediate need for comprehensive studies that focus on skill transfer, which will allow simulation to be incorporated effectively into orthopedic surgery training programs.

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

    Science.gov (United States)

    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

  20. 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

  1. 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

  2. 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

  3. 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

  4. A young surgeon's perspective on alternate surgical training pathways.

    Science.gov (United States)

    Sutherland, Michael J

    2007-02-01

    Most residents in training today are in focused on their training, and the thoughts of changing the structure of residencies and fellowships is something that they are ambivalent about or have never heard anything about. The small minority who are vocal on these issues represent an activist group supporting change. This group is very vocal and raises many of the excellent questions we have examined. In discussion with residents, some feel that shortened training will help with the financial issues facing residents. However, many people today add additional years to their training with research years or "super" fellowships. The residents demonstrate that they want to get the skill sets that they desire despite the added length of training. This is unlikely to change even if the minimum number of years of training changes with the evolution of tracked training programs. Medical students, in the Resident and Associate Society of the American College of Surgeons survey, did not indicate that shortened training would have an affect on decision to pursue or not pursue a surgical career. If the focus of these changes is to encourage medical students to pursue a residency in surgical specialties, we may need to look at other options to increase medical student interest. Medical students indicated that lifestyle issues, types of clinical problems, stress-related concerns, and interactions with the surgical faculty were far more important in their decision to enter a surgical specialty than work hours or duration of training. If we are to make a difference in the quality and quantity of applicants for surgical residencies, then changes in the structure of residencies do not seem to be the most effective way to accomplish this. We should possibly focus more on faculty and medical student interaction and the development of positive role models for medical students to see surgeons with attractive practices that minimize some of the traditionally perceived negative stereotypes

  5. Multimedia-based training on Internet platforms improves surgical performance: a randomized controlled trial.

    Science.gov (United States)

    Pape-Koehler, Carolina; Immenroth, Marc; Sauerland, Stefan; Lefering, Rolf; Lindlohr, Cornelia; Toaspern, Jens; Heiss, Markus

    2013-05-01

    Surgical procedures are complex motion sequences that require a high level of preparation, training, and concentration. In recent years, Internet platforms providing surgical content have been established. Used as a surgical training method, the effect of multimedia-based training on practical surgical skills has not yet been evaluated. This study aimed to evaluate the effect of multimedia-based training on surgical performance. A 2 × 2 factorial, randomized controlled trial with a pre- and posttest design was used to test the effect of multimedia-based training in addition to or without practical training on 70 participants in four groups defined by the intervention used: multimedia-based training, practical training, and combination training (multimedia-based training + practical training) or no training (control group). The pre- and posttest consisted of a laparoscopic cholecystectomy in a Pelvi-Trainer and was video recorded, encoded, and saved on DVDs. These were evaluated by blinded raters using a modified objective structured assessment of technical skills (OSATS). The main evaluation criterion was the difference in OSATS score between the pre- and posttest (ΔOSATS) results in terms of a task-specific checklist (procedural steps scored as correct or incorrect). The groups were homogeneous in terms of demographic parameters, surgical experience, and pretest OSATS scores. The ΔOSATS results were highest in the multimedia-based training group (4.7 ± 3.3; p Multimedia-based training improved surgical performance significantly and thus could be considered a reasonable tool for inclusion in surgical curricula.

  6. 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.

  7. Pregnancy and Motherhood During Surgical Training.

    Science.gov (United States)

    Rangel, Erika L; Smink, Douglas S; Castillo-Angeles, Manuel; Kwakye, Gifty; Changala, Marguerite; Haider, Adil H; Doherty, Gerard M

    2018-03-21

    Although family priorities influence specialty selection and resident attrition, few studies describe resident perspectives on pregnancy during surgical training. To directly assess the resident experience of childbearing during training. A self-administered 74-question survey was electronically distributed in January 2017 to members of the Association of Women Surgeons, to members of the Association of Program Directors in Surgery listserv, and through targeted social media platforms. Surgeons who had 1 or more pregnancies during an Accreditation Council for Graduate Medical Education-accredited US general surgery residency program and completed training in 2007 or later were included. Important themes were identified using focus groups of surgeons who had undergone pregnancy during training in the past 7 years. Additional topics were identified through MEDLINE searches performed from January 2000 to July 2016 combining the keywords pregnancy, resident, attrition, and parenting in any specialty. Descriptive data on perceptions of work schedule during pregnancy, maternity leave policies, lactation and childcare support, and career satisfaction after childbirth. This study included 347 female surgeons (mean [SD] age, 30.5 [2.7] years) with 452 pregnancies. A total of 297 women (85.6%) worked an unmodified schedule until birth, and 220 (63.6%) were concerned that their work schedule adversely affected their health or the health of their unborn child. Residency program maternity leave policies were reported by 121 participants (34.9%). A total of 251 women (78.4%) received maternity leave of 6 weeks or less, and 250 (72.0%) perceived the duration of leave to be inadequate. The American Board of Surgery leave policy was cited as a major barrier to the desired length of leave by 268 of 326 respondents (82.2%). Breastfeeding was important to 329 (95.6%), but 200 (58.1%) stopped earlier than they wished because of poor access to lactation facilities and challenges leaving

  8. Augmented reality to training spatial skills

    OpenAIRE

    Martin-Gutierrez, Jorge; Contero, Manuel; Alcañiz Raya, Mariano Luis

    2015-01-01

    La Laguna University has been offering courses for the development of spatial skills since 2004. Each year since that time spatial ability of engineering students has been measured before and after the courses to check progress after each training session. We have developed a spatial skills training course based on augmented reality and graphic engineering contents, and designed the AR_Dehaes tool, which is based on its own library the uses computer vision techniques for incorporating vis...

  9. Improving efficiency of clinical skills training

    DEFF Research Database (Denmark)

    Tolsgaard, Martin G; Bjørck, Sebastian; Birkvad Rasmussen, Maria

    2013-01-01

    The rising number of medical students and the impact this has on students' learning of clinical skills is a matter of concern. Cooperative learning in pairs, called dyad training, might help address this situation.......The rising number of medical students and the impact this has on students' learning of clinical skills is a matter of concern. Cooperative learning in pairs, called dyad training, might help address this situation....

  10. 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.

  11. Assertiveness Training for Job-Seeking Skills

    Science.gov (United States)

    Ball, Patricia G.; McLoughlin, Mary Ellen

    1977-01-01

    Assertiveness Training for Job-Seeking Skills includes skill development in initiating the job search; arranging actual interviews; preparing a resume; articulating strengths, weaknesses, and career objectives; responding assertively in interviews; asking appropriate questions; accepting or rejecting job offers; confronting discrimination;…

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

    Science.gov (United States)

    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.

  13. Surgical skill and complication rates after bariatric surgery.

    Science.gov (United States)

    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.

  14. Retention of Mastoidectomy Skills After Virtual Reality Simulation Training.

    Science.gov (United States)

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

    2016-07-01

    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. 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. 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 students: 19 from a cohort trained with distributed practice and 17 from a cohort trained with massed practice. Participants performed 2 virtual mastoidectomies in a VR simulator a mean of 3.2 months (range, 2.4-5.0 months) after completing initial training with 12 repeated procedures. Practice blocks were spaced apart in time (distributed), or all procedures were performed in 1 day (massed). Performance of the virtual mastoidectomy as assessed by 2 masked senior otologists using a modified Welling scale, as well as cognitive load as estimated by reaction time to perform a secondary task. Among 36 participants, mastoidectomy final-product skills were largely retained at 3 months (mean change in score, 0.1 points; P = .89) regardless of practice schedule, but the group trained with massed practice took more time to complete the task. The performance of the massed practice group increased significantly from the first to the second retention procedure (mean change, 1.8 points; P = .001), reflecting that skills were less consolidated. For both groups, increases in reaction times in the secondary task (distributed practice group: mean

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

    Science.gov (United States)

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

    2013-08-27

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

  16. Perceptions, training experiences, and preferences of surgical residents toward laparoscopic simulation training: a resident survey.

    Science.gov (United States)

    Shetty, Shohan; Zevin, Boris; Grantcharov, Teodor P; Roberts, Kurt E; Duffy, Andrew J

    2014-01-01

    Simulation training for surgical residents can shorten learning curves, improve technical skills, and expedite competency. Several studies have shown that skills learned in the simulated environment are transferable to the operating room. Residency programs are trying to incorporate simulation into the resident training curriculum to supplement the hands-on experience gained in the operating room. Despite the availability and proven utility of surgical simulators and simulation laboratories, they are still widely underutilized by surgical trainees. Studies have shown that voluntary use leads to minimal participation in a training curriculum. Although there are several simulation tools, there is no clear evidence of the superiority of one tool over the other in skill acquisition. The purpose of this study was to explore resident perceptions, training experiences, and preferences regarding laparoscopic simulation training. Our goal was to profile resident participation in surgical skills simulation, recognize potential barriers to voluntary simulator use, and identify simulation tools and tasks preferred by residents. Furthermore, this study may help to inform whether mandatory/protected training time, as part of the residents' curriculum is essential to enhance participation in the simulation laboratory. A cross-sectional study on general surgery residents (postgraduate years 1-5) at Yale University School of Medicine and the University of Toronto via an online questionnaire was conducted. Overall, 67 residents completed the survey. The institutional review board approved the methods of the study. Overall, 95.5% of the participants believed that simulation training improved their laparoscopic skills. Most respondents (92.5%) perceived that skills learned during simulation training were transferrable to the operating room. Overall, 56.7% of participants agreed that proficiency in a simulation curriculum should be mandatory before operating room experience. The

  17. 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.

  18. 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

  19. Skills training of junior medical students

    African Journals Online (AJOL)

    2013-11-02

    Nov 2, 2013 ... Peer tutors enjoyed and benefited from this teaching method without it negatively affecting their own learning. Discussion. ... addressing the problem of skills training of junior medical students where there is a shortage of trained clinical teachers. AJHPE 2013 ... [1] Informal peer teaching usually takes place.

  20. Evaluation of a Soft Skills Training Program

    Science.gov (United States)

    Charoensap-Kelly, Piyawan; Broussard, Lauren; Lindsly, Mallory; Troy, Megan

    2016-01-01

    This study was conducted to determine the effectiveness of a soft skills employee training program. We examined willingness to learn and delivery methods (face-to-face vs. online) and their associations with the training outcomes in terms of learning and behavioral change. Results showed that neither participants' willingness to learn nor delivery…

  1. An advanced simulator for orthopedic surgical training.

    Science.gov (United States)

    Cecil, J; Gupta, Avinash; Pirela-Cruz, Miguel

    2018-02-01

    The purpose of creating the virtual reality (VR) simulator is to facilitate and supplement the training opportunities provided to orthopedic residents. The use of VR simulators has increased rapidly in the field of medical surgery for training purposes. This paper discusses the creation of the virtual surgical environment (VSE) for training residents in an orthopedic surgical process called less invasive stabilization system (LISS) surgery which is used to address fractures of the femur. The overall methodology included first obtaining an understanding of the LISS plating process through interactions with expert orthopedic surgeons and developing the information centric models. The information centric models provided a structured basis to design and build the simulator. Subsequently, the haptic-based simulator was built. Finally, the learning assessments were conducted in a medical school. The results from the learning assessments confirm the effectiveness of the VSE for teaching medical residents and students. The scope of the assessment was to ensure (1) the correctness and (2) the usefulness of the VSE. Out of 37 residents/students who participated in the test, 32 showed improvements in their understanding of the LISS plating surgical process. A majority of participants were satisfied with the use of teaching Avatars and haptic technology. A paired t test was conducted to test the statistical significance of the assessment data which showed that the data were statistically significant. This paper demonstrates the usefulness of adopting information centric modeling approach in the design and development of the simulator. The assessment results underscore the potential of using VR-based simulators in medical education especially in orthopedic surgery.

  2. 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.

  3. 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.

  4. Integrating Communication and Skills Training.

    Science.gov (United States)

    Bean, Robert

    1994-01-01

    Discusses the need for effective basic language, literacy, numeracy and other communication skills to support all workforce development programs. The general cultural bias towards these programs has marginalized them and is reflected in policy, curriculum and practice. Adjustments are needed in the approaches to the new climate of workplace…

  5. 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

  6. Psychological Readiness and Motor Skills Needed for Toilet Training

    Science.gov (United States)

    ... Text Size Email Print Share Psychological Readiness and Motor Skills Needed for Toilet Training Page Content Article Body ... to see toilet training as a desirable skill. Motor Skills In addition to his physiological development, your child’s ...

  7. 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.

  8. 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.

  9. Mechatronics: Skilled Industrial Job Training

    OpenAIRE

    Bill Jones

    2013-01-01

    Currently, skills required for these jobs are available through many avenues, but we have centered our efforts on a program called mechatronics. Mechatronics combines the industrial fields of electronics, fluid power (hydraulic and pneumatic), mechanics, and computer processing (programmable logic controller, or PLC, and microprocessors). Businesses, community resources, legislators, and educators are beginning to work together in Tennessee and in Rutherford County to develop pathways for K-1...

  10. Cognitive Load in Mastoidectomy Skills Training: Virtual Reality Simulation and Traditional Dissection Compared.

    Science.gov (United States)

    Andersen, Steven Arild Wuyts; Mikkelsen, Peter Trier; Konge, Lars; Cayé-Thomasen, Per; Sørensen, Mads Sølvsten

    2016-01-01

    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. A prospective, crossover study. Participants performed cadaveric dissection before VR simulation of the procedure or vice versa. CL was estimated by secondary-task reaction time testing at baseline and during the procedure in both training modalities. The national Danish temporal bone course. A total of 40 novice otorhinolaryngology residents. Reaction time was increased by 20% in VR simulation training and 55% in cadaveric dissection training of mastoidectomy compared with baseline measurements. Traditional dissection training increased CL significantly more than VR simulation training (p < 0.001). VR simulation training imposed a lower CL than traditional cadaveric dissection training of mastoidectomy. Learning complex 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 in the VR simulation. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  11. 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.

  12. Fresh frozen cadaver workshops for advanced vascular surgical training.

    Science.gov (United States)

    Jansen, Shirley; Cowie, Margaret; Linehan, John; Hamdorf, Jeffery M

    2014-11-01

    Reduction in working hours, streamlined training schemes and increasing use of endovascular techniques has meant a reduction in operative experience for newer vascular surgical trainees, especially those exposures which are not routinely performed such as thoracoabdominal, thoracotomy and retroperitoneal aortic, for example. This paper describes an Advanced Anatomy of Exposure course which was designed and convened at the Clinical Training & Evaluation Centre in Western Australia and uses fresh frozen cadavers. Feedback was obtained from the participants who attended over three courses by questionnaire. Feedback was strongly positive for the course meeting both its learning outcomes and personal learning objectives, and in addition, making a significant contribution to specialty skills. Most participants thought the fresh frozen cadaveric model significantly improved the learning objectives for training. The fresh frozen cadaver is an excellent teaching model highly representative of the living open surgical scenario where advanced trainees and newly qualified consultants can improve their operative confidence and consequently patient safety in vascular surgery. An efficient fresh frozen cadaver teaching programme can benefit many health professionals simultaneously maximizing the use of donated human tissue. © 2013 Royal Australasian College of Surgeons.

  13. 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

  14. Group Music Training and Children's Prosocial Skills.

    Science.gov (United States)

    Schellenberg, E Glenn; Corrigall, Kathleen A; Dys, Sebastian P; Malti, Tina

    2015-01-01

    We investigated if group music training in childhood is associated with prosocial skills. Children in 3rd or 4th grade who attended 10 months of music lessons taught in groups were compared to a control group of children matched for socio-economic status. All children were administered tests of prosocial skills near the beginning and end of the 10-month period. Compared to the control group, children in the music group had larger increases in sympathy and prosocial behavior, but this effect was limited to children who had poor prosocial skills before the lessons began. The effect was evident even when the lessons were compulsory, which minimized the role of self-selection. The results suggest that group music training facilitates the development of prosocial skills.

  15. Group Music Training and Children's Prosocial Skills.

    Directory of Open Access Journals (Sweden)

    E Glenn Schellenberg

    Full Text Available We investigated if group music training in childhood is associated with prosocial skills. Children in 3rd or 4th grade who attended 10 months of music lessons taught in groups were compared to a control group of children matched for socio-economic status. All children were administered tests of prosocial skills near the beginning and end of the 10-month period. Compared to the control group, children in the music group had larger increases in sympathy and prosocial behavior, but this effect was limited to children who had poor prosocial skills before the lessons began. The effect was evident even when the lessons were compulsory, which minimized the role of self-selection. The results suggest that group music training facilitates the development of prosocial skills.

  16. 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...

  17. Education, Training and Skills in Innovation Policy

    DEFF Research Database (Denmark)

    Borrás, Susana; Edquist, Charles

    2015-01-01

    The main question that guides this paper is how governments are focusing (and must focus) on competence building (education, training and skills) when designing and implementing innovation policies. After a brief literature review, this paper suggests a typology of internal/external and individual....../organizational sources of competences that are related to innovation activities. This serves to examine briefly the most common initiatives that governments are taking in this regard. The paper identifies three overall deficiencies and imbalances in innovation systems in terms of education, training and skills...

  18. The learning effect of intraoperative video-enhanced surgical procedure training.

    Science.gov (United States)

    van Det, M J; Meijerink, W J H J; Hoff, C; Middel, L J; Koopal, S A; Pierie, J P E N

    2011-07-01

    The transition from basic skills training in a skills lab to procedure training in the operating theater using the traditional master-apprentice model (MAM) lacks uniformity and efficiency. When the supervising surgeon performs parts of a procedure, training opportunities are lost. To minimize this intervention by the supervisor and maximize the actual operating time for the trainee, we created a new training method called INtraoperative Video-Enhanced Surgical Training (INVEST). Ten surgical residents were trained in laparoscopic cholecystectomy either by the MAM or with INVEST. Each trainee performed six cholecystectomies that were objectively evaluated on an Objective Structured Assessment of Technical Skills (OSATS) global rating scale. Absolute and relative improvements during the training curriculum were compared between the groups. A questionnaire evaluated the trainee's opinion on this new training method. Skill improvement on the OSATS global rating scale was significantly greater for the trainees in the INVEST curriculum compared to the MAM, with mean absolute improvement 32.6 versus 14.0 points and mean relative improvement 59.1 versus 34.6% (P=0.02). INVEST significantly enhances technical and procedural skill development during the early learning curve for laparoscopic cholecystectomy. Trainees were positive about the content and the idea of the curriculum.

  19. 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.

  20. The Pareto Analysis for Establishing Content Criteria in Surgical Training.

    Science.gov (United States)

    Kramp, Kelvin H; van Det, Marc J; Veeger, Nic J G M; Pierie, Jean-Pierre E N

    2016-01-01

    Current surgical training is still highly dependent on expensive operating room (OR) experience. Although there have been many attempts to transfer more training to the skills laboratory, little research is focused on which technical behaviors can lead to the highest profit when they are trained outside the OR. The Pareto principle states that in any population that contributes to a common effect, a few account for the bulk of the effect. This principle has been widely used in business management to increase company profits. This study uses the Pareto principle for establishing content criteria for more efficient surgical training. A retrospective study was conducted to assess verbal guidance provided by 9 supervising surgeons to 12 trainees performing 64 laparoscopic cholecystectomies in the OR. The verbal corrections were documented, tallied, and clustered according to the aimed change in novice behavior. The corrections were rank ordered, and a cumulative distribution curve was used to calculate which corrections accounted for 80% of the total number of verbal corrections. In total, 253 different verbal corrections were uttered 1587 times and were categorized into 40 different clusters of aimed changes in novice behaviors. The 35 highest-ranking verbal corrections (14%) and the 11 highest-ranking clusters (28%) accounted for 80% of the total number of given verbal corrections. Following the Pareto principle, we were able to identify the aspects of trainee behavior that account for most corrections given by supervisors during a laparoscopic cholecystectomy on humans. This strategy can be used for the development of new training programs to prepare the trainee in advance for the challenges encountered in the clinical setting in an OR. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  1. 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)

  2. Effect of music on surgical skill during simulated intraocular surgery.

    Science.gov (United States)

    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.

  3. Implementation of full patient simulation training in surgical residency.

    Science.gov (United States)

    Fernandez, Gladys L; Lee, Patrick C; Page, David W; D'Amour, Elizabeth M; Wait, Richard B; Seymour, Neal E

    2010-01-01

    Simulated patient care has gained acceptance as a medical education tool but is underused in surgical training. To improve resident clinical management in critical situations relevant to the surgical patient, high-fidelity full patient simulation training was instituted at Baystate Medical Center in 2005 and developed during successive years. We define surgical patient simulation as clinical management performed in a high fidelity environment using a manikin simulator. This technique is intended to be specifically modeled experiential learning related to the knowledge, skills, and behaviors that are fundamental to patient care. We report 3 academic years' use of a patient simulation curriculum. Learners were PGY 1-3 residents; 26 simulated patient care experiences were developed based on (1) designation as a critical management problem that would otherwise be difficult to practice, (2) ability to represent the specific problem in simulation, (3) relevance to the American Board of Surgery (ABS) certifying examination, and/or (4) relevance to institutional quality or morbidity and mortality reports. Although training started in 2005, data are drawn from the period of systematic and mandatory training spanning from July 2006 to June 2009. Training occurred during 1-hour sessions using a computer-driven manikin simulator (METI, Sarasota, Florida). Educational content was provided either before or during presimulation briefing sessions. Scenario areas included shock states, trauma and critical care case management, preoperative processes, and postoperative conditions and complications. All sessions were followed by facilitated debriefing. Likert scale-based multi-item assessments of core competency in medical knowledge, patient care, diagnosis, management, communication, and professionalism were used to generate a performance score for each resident for each simulation (percentage of best possible score). Performance was compared across PGYs by repeated

  4. 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.

  5. European Surgical Education and Training in Gynecologic Oncology: The impact of an Accredited Fellowship.

    Science.gov (United States)

    Chiva, Luis M; Mínguez, Jose; Querleu, Denis; Cibula, David; du Bois, Andreas

    2017-05-01

    lead the standardization of surgical training and promote ways of improving members' surgical skills.

  6. General surgery training and robotics: Are residents improving their skills?

    Science.gov (United States)

    Finnerty, Brendan M; Afaneh, Cheguevara; Aronova, Anna; Fahey, Thomas J; Zarnegar, Rasa

    2016-02-01

    While robotic-assisted operations have become more prevalent, many general surgery residencies do not have a formal robotic training curriculum. We sought to ascertain how well current general surgery training permits acquisition of robotic skills by comparing robotic simulation performance across various training levels. Thirty-six participants were categorized by level of surgical training: eight medical students (MS), ten junior residents (JR), ten mid-level residents (MLR), and eight senior residents (SR). Participants performed three simulation tasks on the da Vinci (®) Skills Simulator (MatchBoard, EnergyDissection, SutureSponge). Each task's scores (0-100) and cumulative scores (0-300) were compared between groups. There were no differences in sex, hand dominance, video gaming history, or prior robotic experience between groups; however, SR was the oldest (p Robotic skillsets acquired during general surgery residency show minimal improvement during the course of training, although laparoscopic experience is correlated with advanced robotic task performance. Changes in residency curricula or pursuit of fellowship training may be warranted for surgeons seeking proficiency.

  7. Sibling Conflict Resolution Skills: Assessment and Training

    Science.gov (United States)

    Thomas, Brett W.; Roberts, Mark W.

    2009-01-01

    Sibling conflict can rise to the level of a clinical problem. In Phase 1 a lengthy behavioral role-play analog sampling child reactions to normal sibling conflicts was successfully shortened. In Phase 2 normal children who lacked sibling conflict resolution skills were randomly assigned to a Training or Measurement Only condition. Training…

  8. The Skills Enhancement Training Program. Performance Report.

    Science.gov (United States)

    Food and Beverage Workers Union, Local 32, Washington, DC.

    This report describes a joint labor-management workplace literacy program called SET (Skills Enhancement Training) that targeted the more than 2,000 unionized employees of food service contractors at U.S. government institutions in Washington, D.C. Nineteen classes were offered and a total of 191 people self-selected themselves into the program.…

  9. Approaching time is important for assessment of endoscopic surgical skills.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  11. 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.

  12. Verification of Accurate Technical Insight: A Prerequisite for Self-Directed Surgical Training

    Science.gov (United States)

    Hu, Yinin; Kim, Helen; Mahmutovic, Adela; Choi, Joanna; Le, Ivy; Rasmussen, Sara

    2015-01-01

    Simulation-based surgical skills training during preclinical education is a persistent challenge due to time constraints of trainees and instructors alike. Self-directed practice is resource-efficient and flexible; however, insight into technical proficiency among trainees is often lacking. The purpose of this study is to prospectively assess the…

  13. Improving core surgical training in a major trauma centre.

    Science.gov (United States)

    Morris, Daniel L J; Bryson, David J; Ollivere, Ben J; Forward, Daren P

    2016-06-01

    English Major Trauma Centres (MTCs) were established in April 2012. Increased case volume and complexity has influenced trauma and orthopaedic (T&O) core surgical training in these centres. To determine if T&O core surgical training in MTCs meets Joint Committee on Surgical Training (JCST) quality indicators including performance of T&O operative procedures and consultant supervised session attendance. An audit cycle assessing the impact of a weekly departmental core surgical trainee rota. The rota included allocated timetabled sessions that optimised clinical and surgical learning opportunities. Intercollegiate Surgical Curriculum Programme (ISCP) records for T&O core surgical trainees at a single MTC were analysed for 8 months pre and post rota introduction. Outcome measures were electronic surgical logbook evidence of leading T&O operative procedures and consultant validated work-based assessments (WBAs). Nine core surgical trainees completed a 4 month MTC placement pre and post introduction of the core surgical trainee rota. Introduction of core surgical trainee rota significantly increased the mean number of T&O operative procedures led by a core surgical trainee during a 4 month MTC placement from 20.2 to 34.0 (pcore surgical trainee during a 4 month MTC placement was significantly increased (0.3 vs 2.4 [p=0.04]). Those of dynamic hip screw fixation (2.3 vs 3.6) and ankle fracture fixation (0.7 vs 1.6) were not. Introduction of a core surgical trainee rota significantly increased the mean number of consultant validated WBAs completed by a core surgical trainee during a 4 month MTC placement from 1.7 to 6.6 (pcore surgical trainee rota utilising a 'problem-based' model can significantly improve T&O core surgical training in MTCs. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. 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.

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

    Science.gov (United States)

    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.

  16. 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.

  17. 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

  18. Group Music Training and Children's Prosocial Skills

    OpenAIRE

    Schellenberg, E. Glenn; Corrigall, Kathleen A.; Dys, Sebastian P.; Malti, Tina

    2015-01-01

    We investigated if group music training in childhood is associated with prosocial skills. Children in 3rd or 4th grade who attended 10 months of music lessons taught in groups were compared to a control group of children matched for socio-economic status. All children were administered tests of prosocial skills near the beginning and end of the 10-month period. Compared to the control group, children in the music group had larger increases in sympathy and prosocial behavior, but this effect w...

  19. 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.

  20. Training and Assessment of Hysteroscopic Skills

    DEFF Research Database (Denmark)

    Savran, Mona Meral; Sørensen, Stine Maya Dreier; Konge, Lars

    2016-01-01

    OBJECTIVE: The aim of this systematic review was to identify studies on hysteroscopic training and assessment. DESIGN: PubMed, Excerpta Medica, the Cochrane Library, and Web of Science were searched in January 2015. Manual screening of references and citation tracking were also performed. Studies...... on hysteroscopic educational interventions were selected without restrictions on study design, populations, language, or publication year. A qualitative data synthesis including the setting, study participants, training model, training characteristics, hysteroscopic skills, assessment parameters, and study...... outcomes was performed by 2 authors working independently. Effect sizes were calculated when possible. Overall, 2 raters independently evaluated sources of validity evidence supporting the outcomes of the hysteroscopy assessment tools. RESULTS: A total of 25 studies on hysteroscopy training were identified...

  1. Communication skills: a new strategy for training

    Directory of Open Access Journals (Sweden)

    Shane A. Gordon

    1996-12-01

    Full Text Available In 1993 the General Medical Council (GMC published Tomorrow's Doctors, a set of recommendations for medical education. Much of this document was concerned with the training of communication skills and how this could be improved. This recommendation follows decades of evidence about the importance of communication from many widely respected medical teachers from every discipline: Doctors can discharge (their important tasks effectively only if they possess the relevant skills. Unfortunately, many do not appear to acquire them during their professional training. (Maguire, 1981 There appears to be a failure sometimes to notice what is really being said… the doctor avoids the acute discomfort of being aware of a problem in which he would rather not get involved. (Norell, 1972.

  2. A New Robotic Platform for Endoscopic Skill Training

    Directory of Open Access Journals (Sweden)

    Mirella Mogiatti

    2014-02-01

    Full Text Available Background: Applications of Minimally Invasive Surgery (MIS techniques are quickly extending. Therefore, also surgical education is changing rapidly, although several factors, including budget constraints and medico-legal concerns, still limit opportunities for pediatric trainees. New training devices, such as low fidelity bench trainers and virtual reality simulators, offer new ways for surgical training. Moreover, there is considerable interest in the development of haptic simulators for MIS even though the importance of force feedback remains poorly understood. Methods: In this report, we present the LapLab (Laparoscopic Laboratory device, an innovative laparoscopic training solution developed at the University of Bologna. Results: LapLab is a haptic simulator for MIS designed to improve and test the skill of surgeons. Moreover, it also allows to test in safe conditions (i.e. by means of realistic simulations new kinds of MIS instruments. Conclusions: Actually the LapLab simulation system has matured from a technological point of view, but still it represents just a starting point for a new generation of simulation systems able to give a real contribute to the education and training of the surgeons of tomorrow.

  3. 10 CFR 835.103 - Education, training and skills.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Education, training and skills. 835.103 Section 835.103... § 835.103 Education, training and skills. Individuals responsible for developing and implementing... education, training, and skills to discharge these responsibilities. [63 FR 59682, Nov. 4, 1998] ...

  4. Training considerations for the intracoelomic implantation of electronic tags in fish with a summary of common surgical errors

    Energy Technology Data Exchange (ETDEWEB)

    Cooke, Steven J.; Wagner, Glenn N.; Brown, Richard S.; Deters, Katherine A.

    2011-01-01

    Training is a fundamental part of all scientific and technical disciplines. This is particularly true for all types of surgeons. For surgical procedures, a number of skills are necessary to reduce mistakes. Trainees must learn an extensive yet standardized set of problem-solving and technical skills to handle challenges as they arise. There are currently no guidelines or consistent training methods for those intending to implant electronic tags in fish; this is surprising, considering documented cases of negative consequences of fish surgeries and information from studies having empirically tested fish surgical techniques. Learning how to do fish surgery once is insufficient for ensuring the maintenance or improvement of surgical skill. Assessment of surgical skills is rarely incorporated into training, and is needed. Evaluation provides useful feedback that guides future learning, fosters habits of self-reflection and self-remediation, and promotes access to advanced training. Veterinary professionals should be involved in aspects of training to monitor basic surgical principles. We identified attributes related to knowledge, understanding, and skill that surgeons must demonstrate prior to performing fish surgery including a “hands-on” assessment using live fish. Included is a summary of common problems encountered by fish surgeons. We conclude by presenting core competencies that should be required as well as outlining a 3-day curriculum for training surgeons to conduct intracoelomic implantation of electronic tags. This curriculum could be offered through professional fisheries societies as professional development courses.

  5. Training diagnostic skills for nuclear power plants

    International Nuclear Information System (INIS)

    Goodstein, L.P.

    1986-11-01

    Operators of large-scale industrial process plants such as nuclear power stations and chemical plants are faced with a critical and complex task when confronted with disturbances in normal operation caused by technical failures or mainte- nances errors. Great care must be taken to prepare and support the operators during such situations. Procedural systems are provided, trained on full-scale highfidelity simulators is often a prerequisite and decision-support systems are starting to be incorporated, especially in modern control rooms. During recent years, it has become increasingly clear from ''real-life'' studies in complex production and transport industries that professional highly skilled troubleshooters can develop effective general purpose search strategies for locating and dealing with faults and, most importantly, with new and not previously experienced faults. This research has indicated that means for training of these general diagnostic abilities can be developed. In addition, other work has dealt with the problem of observing and analyzing operator behaviour in coping with disturbances. The NKA/LIT-4 project has continued these efforts in studying methods for training diagnostic skills as well as for observing and testing operator behaviour on training simulators. (author)

  6. Evaluating Behavioral Skills Training to Teach Safe Tackling Skills to Youth Football Players

    Science.gov (United States)

    Tai, Sharayah S. M.; Miltenberger, Raymond G.

    2017-01-01

    With concussion rates on the rise for football players, there is a need for further research to increase skills and decrease injuries. Behavioral skills training is effective in teaching a wide variety of skills but has yet to be studied in the sports setting. We evaluated behavioral skills training to teach safer tackling techniques to six…

  7. 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.

  8. 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.

  9. Psychomotor skills training in pediatric airway endoscopy simulation.

    Science.gov (United States)

    Jabbour, Noel; Reihsen, Troy; Sweet, Robert M; Sidman, James D

    2011-07-01

    To develop a robust psychomotor skills curriculum to teach pediatric airway foreign body retrieval and to assess the effect of this curriculum on residents' confidence in and ability to perform the complete task in an infant airway mannequin. Instructional course. Objective Structured Assessment of Technical Skills (OSATS). Surgical simulation laboratory. A half-day simulation-based course was developed to train otolaryngology residents in bronchoscopic foreign body retrieval. This complex psychomotor skill was deconstructed into subtasks. The following curricular learning objectives were presented and assessed: understanding of tracheobronchial anatomy, ability to adequately visualize the larynx with laryngoscopy, proficiency in rigid bronchoscopy, and familiarity with foreign body instrumentation. Residents were objectively evaluated on their ability to perform the complete task on a simulator before and after the course using an OSATS grading system. Confidence in successfully assembling the instruments and completing the task was assessed at these time periods. Seventeen otolaryngology residents completed the study. Confidence in assembling the instruments and in performing the complete task increased on average by 81% and 43%, respectively (P < .001). Using a 15-point OSATS grading system, the average score for the precourse was 7 and for the postcourse was 11.3 (P < .001). Simulation-based subtask training shows promise as an effective and reproducible method to teach the complex psychomotor task of airway foreign body retrieval. Completion of the curriculum led to a significant improvement in residents' confidence in and ability to perform bronchoscopic foreign body retrieval in an infant airway mannequin.

  10. 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.

  11. A perspective on the role and utility of haptic feedback in laparoscopic skills training.

    Science.gov (United States)

    Singapogu, Ravikiran; Burg, Timothy; Burg, Karen J L; Smith, Dane E; Eckenrode, Amanda H

    2014-01-01

    Laparoscopic surgery is a minimally invasive surgical technique with significant potential benefits to the patient, including shorter recovery time, less scarring, and decreased costs. There is a growing need to teach surgical trainees this emerging surgical technique. Simulators, ranging from simple "box" trainers to complex virtual reality (VR) trainers, have emerged as the most promising method for teaching basic laparoscopic surgical skills. Current box trainers require oversight from an expert surgeon for both training and assessing skills. VR trainers decrease the dependence on expert teachers during training by providing objective, real-time feedback and automatic skills evaluation. However, current VR trainers generally have limited credibility as a means to prepare new surgeons and have often fallen short of educators' expectations. Several researchers have speculated that the missing component in modern VR trainers is haptic feedback, which refers to the range of touch sensations encountered during surgery. These force types and ranges need to be adequately rendered by simulators for a more complete training experience. This article presents a perspective of the role and utility of haptic feedback during laparoscopic surgery and laparoscopic skills training by detailing the ranges and types of haptic sensations felt by the operating surgeon, along with quantitative studies of how this feedback is used. Further, a number of research studies that have documented human performance effects as a result of the presence of haptic feedback are critically reviewed. Finally, key research directions in using haptic feedback for laparoscopy training simulators are identified.

  12. A review of training research and virtual reality simulators for the da Vinci surgical system.

    Science.gov (United States)

    Liu, May; Curet, Myriam

    2015-01-01

    PHENOMENON: Virtual reality simulators are the subject of several recent studies of skills training for robot-assisted surgery. Yet no consensus exists regarding what a core skill set comprises or how to measure skill performance. Defining a core skill set and relevant metrics would help surgical educators evaluate different simulators. This review draws from published research to propose a core technical skill set for using the da Vinci surgeon console. Publications on three commercial simulators were used to evaluate the simulators' content addressing these skills and associated metrics. An analysis of published research suggests that a core technical skill set for operating the surgeon console includes bimanual wristed manipulation, camera control, master clutching to manage hand position, use of third instrument arm, activating energy sources, appropriate depth perception, and awareness of forces applied by instruments. Validity studies of three commercial virtual reality simulators for robot-assisted surgery suggest that all three have comparable content and metrics. However, none have comprehensive content and metrics for all core skills. INSIGHTS: Virtual reality simulation remains a promising tool to support skill training for robot-assisted surgery, yet existing commercial simulator content is inadequate for performing and assessing a comprehensive basic skill set. The results of this evaluation help identify opportunities and challenges that exist for future developments in virtual reality simulation for robot-assisted surgery. Specifically, the inclusion of educational experts in the development cycle alongside clinical and technological experts is recommended.

  13. Training spatial skills in men and women.

    Science.gov (United States)

    Cherney, Isabelle D; Bersted, Kyle; Smetter, Joseph

    2014-08-01

    Recent studies suggest that even short-term video game training may transfer to other cognitive tasks. With the popularity of the Nintendo Wii with women, more of them might be exposed to the games that will increase their mental rotation skills. Because performance on mental rotation tests (MRT) has been linked to math performance in women, and thus may ultimately contribute to the under representation of women in STEM fields, it is important to continue to explore ways to decrease or eliminate the robust sex difference in mental rotation. The present study of 30 men and 30 women provides additional evidence that women may benefit from short-term (1 hour) training on either a Nintendo Wii™ or GameCube console to increase their mental rotation skills. One hour of video game training not only increased women's MRT scores to a level similar to men's scores, but also produced greater average improvement for women, even when controlling for experiential factors such as spatial and masculine childhood activities that could contribute to the sex difference in spatial ability.

  14. Two Reading Assessments for Youth in Alternative Basic Skills and Livelihood Skills Training Programs

    Science.gov (United States)

    Comings, John P.; Strucker, John; Bell, Brenda

    2017-01-01

    This article describes two assessment tools that have been used to assess the reading skills of youth participating in alternative basic skills and livelihood skills training programs. The Rapid Assessment of Reading Skills (RARS) was developed to identify potential participants who needed to improve their reading skills before beginning training…

  15. ORIGINAL ARTICLES Ethics and surgical training in ancient India ...

    African Journals Online (AJOL)

    2008-03-01

    Mar 1, 2008 ... Ancient India's contributions to ethics and surgical training ... business of health care becomes increasingly venal. Doctors are better informed .... 'Friendship, sympathy towards the sick, interest in cases .... Textbook of Surgery.

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

    Science.gov (United States)

    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.

  17. [Simulation-based robot-assisted surgical training].

    Science.gov (United States)

    Kolontarev, K B; Govorov, A V; Rasner, P I; Sheptunov, S A; Prilepskaya, E A; Maltsev, E G; Pushkar, D Yu

    2015-12-01

    Since the first use of robotic surgical system in 2000, the robot-assisted technology has gained wide popularity throughout the world. Robot-assisted surgical training is a complex issue that requires significant efforts from students and teacher. During the last two decades, simulation-based training had received active development due to wide-spread occurrence and popularization of laparoscopic and robot-assisted surgical techniques. We performed a systematic review to identify the currently available simulators for robot-assisted surgery. We searched the Medline and Pubmed, English sources of literature data, using the following key words and phrases: "robotics", "robotic surgery", "computer assisted surgery", "simulation", "computer simulation", "virtual reality", "surgical training", and "surgical education". There were identified 565 publications, which meet the key words and phrases; 19 publications were selected for the final analysis. It was established that simulation-based training is the most promising teaching tool that can be used in the training of the next generation robotic surgeons. Today the use of simulators to train surgeons is validated. Price of devices is an obvious barrier for inclusion in the program for training of robotic surgeons, but the lack of this tool will result in a sharp increase in the duration of specialists training.

  18. 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.

  19. Developing Top Managers: The Impact of Interpersonal Skills Training.

    Science.gov (United States)

    Hunt, John W.; Baruch, Yehuda

    2003-01-01

    A study assessed the impact of interpersonal skills training on top managers (n=252) by analyzing feedback from subordinates. The skills most responsive to training had clear objectives and outcome criteria and could be expressed as step-by-step routines. Soft skills were more difficult to improve in this way. (Contains 62 references.) (JOW)

  20. 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.

  1. Psychomotor testing predicts rate of skill acquisition for proficiency-based laparoscopic skills training.

    Science.gov (United States)

    Stefanidis, Dimitrios; Korndorffer, James R; Black, F William; Dunne, J Bruce; Sierra, Rafael; Touchard, Cheri L; Rice, David A; Markert, Ronald J; Kastl, Peter R; Scott, Daniel J

    2006-08-01

    Laparoscopic simulator training translates into improved operative performance. Proficiency-based curricula maximize efficiency by tailoring training to meet the needs of each individual; however, because rates of skill acquisition vary widely, such curricula may be difficult to implement. We hypothesized that psychomotor testing would predict baseline performance and training duration in a proficiency-based laparoscopic simulator curriculum. Residents (R1, n = 20) were enrolled in an IRB-approved prospective study at the beginning of the academic year. All completed the following: a background information survey, a battery of 12 innate ability measures (5 motor, and 7 visual-spatial), and baseline testing on 3 validated simulators (5 videotrainer [VT] tasks, 12 virtual reality [minimally invasive surgical trainer-virtual reality, MIST-VR] tasks, and 2 laparoscopic camera navigation [LCN] tasks). Participants trained to proficiency, and training duration and number of repetitions were recorded. Baseline test scores were correlated to skill acquisition rate. Cutoff scores for each predictive test were calculated based on a receiver operator curve, and their sensitivity and specificity were determined in identifying slow learners. Only the Cards Rotation test correlated with baseline simulator ability on VT and LCN. Curriculum implementation required 347 man-hours (6-person team) and 795,000 dollars of capital equipment. With an attendance rate of 75%, 19 of 20 residents (95%) completed the curriculum by the end of the academic year. To complete training, a median of 12 hours (range, 5.5-21), and 325 repetitions (range, 171-782) were required. Simulator score improvement was 50%. Training duration and repetitions correlated with prior video game and billiard exposure, grooved pegboard, finger tap, map planning, Rey Figure Immediate Recall score, and baseline performance on VT and LCN. The map planning cutoff score proved most specific in identifying slow learners

  2. Face validity of a Wii U video game for training basic laparoscopic skills

    NARCIS (Netherlands)

    Jalink, Maarten B.; Goris, Jetse; Heineman, Erik; Pierie, Jean-Pierre E. N.; Hoedemaker, Henk O. ten Cate

    a BACKGROUND: Although the positive effects of playing video games on basic laparoscopic skills have been studied for several years, no games are actually used in surgical training. This article discusses the face validity of the first video game and custom-made hardware, which takes advantage of

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

    Science.gov (United States)

    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.

  4. Integrating Research Skills Training into Non--Research Methods Courses

    Science.gov (United States)

    Woolf, Jules

    2014-01-01

    Research skills are a valued commodity by industry and university administrators. Despite the importance placed on these skills students typically dislike taking research method courses where these skills are learned. However, training in research skills does not necessarily have to be confined to these courses. In this study participants at a…

  5. Effectiveness of communication skills training for dental students.

    NARCIS (Netherlands)

    ter Horst, G.; Leeds, J.G.; Hoogstraten, J.

    1984-01-01

    27 1st-yr dental students participated in a 3-day communication-skills training, and 39 nonparticipating 1st-yr dental students served as controls, to investigate the short-term effects of the training on participating Ss' communication skills. The general objective of the training was to advance

  6. Electronic device for endosurgical skills training (EDEST): study of reliability.

    Science.gov (United States)

    Pagador, J B; Uson, J; Sánchez, M A; Moyano, J L; Moreno, J; Bustos, P; Mateos, J; Sánchez-Margallo, F M

    2011-05-01

    Minimally Invasive Surgery procedures are commonly used in many surgical practices, but surgeons need specific training models and devices due to its difficulty and complexity. In this paper, an innovative electronic device for endosurgical skills training (EDEST) is presented. A study on reliability for this device was performed. Different electronic components were used to compose this new training device. The EDEST was focused on two basic laparoscopic tasks: triangulation and coordination manoeuvres. A configuration and statistical software was developed to complement the functionality of the device. A calibration method was used to assure the proper work of the device. A total of 35 subjects (8 experts and 27 novices) were used to check the reliability of the system using the MTBF analysis. Configuration values for triangulation and coordination exercises were calculated as 0.5 s limit threshold and 800-11,000 lux range of light intensity, respectively. Zero errors in 1,050 executions (0%) for triangulation and 21 errors in 5,670 executions (0.37%) for coordination were obtained. A MTBF of 2.97 h was obtained. The results show that the reliability of the EDEST device is acceptable when used under previously defined light conditions. These results along with previous work could demonstrate that the EDEST device can help surgeons during first training stages.

  7. Systematic review of the implementation of simulation training in surgical residency curriculum.

    Science.gov (United States)

    Kurashima, Yo; Hirano, Satoshi

    2017-07-01

    We reviewed the literature regarding the specific methods and strategies for implementing simulation-based training into the modern surgical residency curriculum. Residency programs are still struggling with how best to implement it into their curricula from a practical viewpoint. A systematic review was performed using Ovid MEDLINE, EMBASE, PubMed, PsycINFO, Web of Science, and other resources for studies involving the use of simulation for technical skills training in the surgical residency curriculum. Studies were selected based on the integration of simulation into the curriculum and/or a description of the details of implementation and the resources required. In total, 2533 unique citations were retrieved based on this search, and 31 articles met the inclusion criteria. Most simulators were focused on laparoscopic procedures, and training occurred most often in a skills lab. The assessment of skills consisted mostly of speed of task completion. Only 4 studies addressed issues of cost, and 6 programs mentioned human resources without any mention of skills center personnel or administrative support. All of the studies described the nature of the simulation training, but very few commented on how it was actually implemented and what was needed from organizational, administrative and logistical perspectives.

  8. Social Skills Training with Mildly Retarded Young Adults.

    Science.gov (United States)

    Meredith, R. L.; And Others

    1980-01-01

    Group behavioral social skills training was more effective than the control condition in increasing positive social behavior, attention to the transaction, and degree of empathy. It was also more effective in decreasing negative social skill behavior. (Author)

  9. Effects of a psychological skills training programme for underserved ...

    African Journals Online (AJOL)

    Effects of a psychological skills training programme for underserved rugby ... The development of psychological skills is an important, but often neglected part of ... Repeated measures two-way ANOVAs revealed significant main time effects, ...

  10. A cost-effective approach to establishing a surgical skills laboratory.

    Science.gov (United States)

    Berg, David A; Milner, Richard E; Fisher, Carol A; Goldberg, Amy J; Dempsey, Daniel T; Grewal, Harsh

    2007-11-01

    Recent studies comparing inexpensive low-fidelity box trainers to expensive computer-based virtual reality systems demonstrate similar acquisition of surgical skills and transferability to the clinical setting. With new mandates emerging that all surgical residency programs have access to a surgical skills laboratory, we describe our cost-effective approach to teaching basic and advanced open and laparoscopic skills utilizing inexpensive bench models, box trainers, and animate models. Open models (basic skills, bowel anastomosis, vascular anastomosis, trauma skills) and laparoscopic models (basic skills, cholecystectomy, Nissen fundoplication, suturing and knot tying, advanced in vivo skills) are constructed using a combination of materials found in our surgical research laboratories, retail stores, or donated by industry. Expired surgical materials are obtained from our hospital operating room and animal organs from food-processing plants. In vivo models are performed in an approved research facility. Operation, maintenance, and administration of the surgical skills laboratory are coordinated by a salaried manager, and instruction is the responsibility of all surgical faculty from our institution. Overall, the cost analyses of our initial startup costs and operational expenditures over a 3-year period revealed a progressive decrease in yearly cost per resident (2002-2003, $1,151; 2003-2004, $1,049; and 2004-2005, $982). Our approach to surgical skills education can serve as a template for any surgery program with limited financial resources.

  11. Coordinated Multiple Cadaver Use for Minimally Invasive Surgical Training

    Science.gov (United States)

    Blaschko, Sarah D.; Brooks, H. Mark; Dhuy, S. Michael; Charest-Shell, Cynthia; Clayman, Ralph V.

    2007-01-01

    Background: The human cadaver remains the gold standard for anatomic training and is highly useful when incorporated into minimally invasive surgical training programs. However, this valuable resource is often not used to its full potential due to a lack of multidisciplinary cooperation. Herein, we propose the coordinated multiple use of individual cadavers to better utilize anatomical resources and potentiate the availability of cadaver training. Methods: Twenty-two postgraduate surgeons participated in a robot-assisted surgical training course that utilized shared cadavers. All participants completed a Likert 4-scale satisfaction questionnaire after their training session. Cadaveric tissue quality and the quality of the training session related to this material were assessed. Results: Nine participants rated the quality of the cadaveric tissue as excellent, 7 as good, 5 as unsatisfactory, and 1 as poor. Overall, 72% of participants who operated on a previously used cadaver were satisfied with their training experience and did not perceive the previous use deleterious to their training. Conclusion: The coordinated use of cadavers, which allows for multiple cadaver use for different teaching sessions, is an excellent training method that increases availability of human anatomical material for minimally invasive surgical training. PMID:18237501

  12. 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.

  13. Basic visual observation skills training course: Appendix A. Final report

    International Nuclear Information System (INIS)

    Toquam, J.L.; Morris, F.A.; Griggs, J.R.

    1995-06-01

    The purpose of the basic visual observation skills course is to help safeguards inspectors evaluate and improve their skills in making observations during inspections and in evaluating and interpreting this information. The first 12 hours of the course provide training in five skill areas: perception and recognition; attention to detail; memory; mental imaging, mapping, and modeling skills; and judgment and decision making. Following this training is an integrating exercise involving a simulated safeguards inspection. This report contains the course manual and materials

  14. Basic visual observation skills training course: Appendix A. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Toquam, J.L.; Morris, F.A.; Griggs, J.R.

    1995-06-01

    The purpose of the basic visual observation skills course is to help safeguards inspectors evaluate and improve their skills in making observations during inspections and in evaluating and interpreting this information. The first 12 hours of the course provide training in five skill areas: perception and recognition; attention to detail; memory; mental imaging, mapping, and modeling skills; and judgment and decision making. Following this training is an integrating exercise involving a simulated safeguards inspection. This report contains the course manual and materials.

  15. Improving the interview skills of college students using behavioral skills training.

    Science.gov (United States)

    Stocco, Corey S; Thompson, Rachel H; Hart, John M; Soriano, Heidi L

    2017-07-01

    Obtaining a job as a college graduate is partly dependent on interview performance. We used a multiple baseline design across skills to evaluate the effects of behavioral skills training with self-evaluation for five college students. Training effects were evaluated using simulated interviews as baseline and posttraining assessments. All participants acquired targeted skills, but we observed some individual differences. Participants were satisfied with training outcomes and rated the procedures as acceptable. Furthermore, ratings from university staff who provide interview training indicated that training improved performance across several skills for the majority of participants. © 2017 Society for the Experimental Analysis of Behavior.

  16. Basic visual observation skills training course: Appendix B. Final report

    International Nuclear Information System (INIS)

    Toquam, J.L.; Morris, F.A.; Griggs, J.R.

    1995-06-01

    The purpose of the basic visual observation skills course is to help safeguards inspectors evaluate and improve their skills in making observations during inspections and in evaluating and interpreting this information. The first 12 hours of the course provide training in five skill areas: perception and recognition; attention to detail; memory; mental imaging, mapping, and modeling skills; and judgment and decision making. Following this training is an integrating exercise involving a simulated safeguards inspection. This report contains the in-class exercises in the five skill areas; pre- and post-course exercises in closure, hidden figures, map memory, and mental rotations; the final examination; a training evaluation form; and the integrating exercise

  17. Basic visual observation skills training course: Appendix B. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Toquam, J.L.; Morris, F.A.; Griggs, J.R.

    1995-06-01

    The purpose of the basic visual observation skills course is to help safeguards inspectors evaluate and improve their skills in making observations during inspections and in evaluating and interpreting this information. The first 12 hours of the course provide training in five skill areas: perception and recognition; attention to detail; memory; mental imaging, mapping, and modeling skills; and judgment and decision making. Following this training is an integrating exercise involving a simulated safeguards inspection. This report contains the in-class exercises in the five skill areas; pre- and post-course exercises in closure, hidden figures, map memory, and mental rotations; the final examination; a training evaluation form; and the integrating exercise.

  18. Evaluating Behavioral Skills Training with and without Simulated in Situ Training for Teaching Safety Skills to Children

    Science.gov (United States)

    Miltenberger, Raymond; Gross, Amy; Knudson, Peter; Bosch, Amanda; Jostad, Candice; Breitwieser, Carrie Brower

    2009-01-01

    This study compared the effectiveness of behavioral skills training (BST) to BST plus simulated in situ training (SIT) for teaching safety skills to children to prevent gun play. The results were evaluated in a posttest only control group design. Following the first assessment, participants in both training groups and the control group who did not…

  19. Workplace-based assessment in surgical training: experiences from the Intercollegiate Surgical Curriculum Programme.

    Science.gov (United States)

    Eardley, Ian; Bussey, Maria; Woodthorpe, Adrian; Munsch, Chris; Beard, Jonathan

    2013-06-01

    The Intercollegiate Surgical Curriculum Programme was launched in the United Kingdom in 2007. At its heart was the reliance upon clear, defined curricula, competence-based training and the use of workplace-based assessments to assess the competence. The principle assessments used were Case-based Discussion, Procedure-based Assessments (PBA), Direct Observation of Procedural Skills, and Clinical Evaluation Exercise and a Multisource Feedback tool. We report the initial experience with that system, and most importantly, the experience with workplace-based assessment. Themes include issues around faculty development, misuse of assessments, inappropriate timing of assessments, concerns about validity and reliability of the assessments and concerns about the actual process of workplace-based assessments. Of the assessments, the PBA performed best. As a consequence, there has been an increased focus upon faculty development, while some of the assessments have been redesigned in line with the PBA. A global rating scale has been introduced that uses clinical anchors. The rating scales have also been altered with a reduction in the number of ratings while an enhanced description of the complexity of the case has been introduced within the Case-based Discussion and the Clinical Evaluation Exercise. A re-evaluation will take place in the near future. © 2013 The Authors. ANZ Journal of Surgery © 2013 Royal Australasian College of Surgeons.

  20. The Effects of Basketball Basic Skills Training on Gross Motor Skills Development of Female Children

    Science.gov (United States)

    Bayazit, Betul

    2015-01-01

    The purpose of this study was to investigate the effects of basketball basic skills training on gross motor skills development of female children in Turkey. For that purpose, 40 female children took part in the study voluntarily. Basketball basic skills test was used to improve the gross motor skills of the female children in the study. Also,…

  1. Mental training in surgical education: a systematic review.

    Science.gov (United States)

    Davison, Sara; Raison, Nicholas; Khan, Muhammad S; Dasgupta, Prokar; Ahmed, Kamran

    2017-11-01

    Pressures on surgical education from restricted working hours and increasing scrutiny of outcomes have been compounded by the development of highly technical surgical procedures requiring additional specialist training. Mental training (MT), the act of performing motor tasks in the 'mind's eye', offers the potential for training outside the operating room. However, the technique is yet to be formally incorporated in surgical curricula. This study aims to review the available literature to determine the role of MT in surgical education. EMBASE and Medline databases were searched. The primary outcome measure was surgical proficiency following training. Secondary analyses examined training duration, forms of MT and trainees level of experience. Study quality was assessed using Consolidated Standards of Reporting Trials scores or Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group. Fourteen trials with 618 participants met the inclusion criteria, of which 11 were randomized and three longitudinal. Ten studies found MT to be beneficial. Mental rehearsal was the most commonly used form of training. No significant correlation was found between the length of MT and outcomes. MT benefitted expert surgeons more than medical students or novice surgeons. The majority studies demonstrate MT to be beneficial in surgical education especially amongst more experienced surgeons within a well-structured MT programme. However, overall studies were low quality, lacked sufficient methodology and suffered from small sample sizes. For these reasons, further research is required to determine optimal role of MT as a supplementary educational tool within the surgical curriculum. © 2017 Royal Australasian College of Surgeons.

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

    NARCIS (Netherlands)

    van Dongen, Koen Willem

    2010-01-01

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

  3. Skills training in laboratory and clerkship: connections, similarities, and differences

    Directory of Open Access Journals (Sweden)

    Berit Eika, MD, PhD

    2003-03-01

    Full Text Available Context: During the third semester of a 6 year long curriculum medical students train clinical skills in the skills laboratory (2 hours per week for 9 weeks as well as in an early, 8 week clinical clerkship at county hospitals. Objectives: to study students’ expectations and attitudes towards skills training in the skills laboratory and clerkship. Subjects: 126 medical students in their 3rd semester. Methods: During the fall of 2001 three consecutive, constructed questionnaires were distributed prior to laboratory training, following laboratory training but prior to clerkships, and following clerkships respectively. Results: Almost all (98% respondents found that training in skills laboratory improved the outcome of the early clerkship and 70% believed in transferability of skills from the laboratory setting to clerkship. Still, a majority (93% of students thought that the clerkship provided students with a better opportunity to learn clinical skills when compared to the skills laboratory. Skills training in laboratory as well as in clerkship motivated students for becoming doctors. Teachers in both settings were perceived as being committed to their teaching jobs, to demonstrate skills prior to practice, and to give students feed back with a small but significant more positive rating of the laboratory. Of the 22 skills that students had trained in the laboratory, a majority of students tried out skills associated with physical examination in the clerkship, whereas only a minority of students tried out more intimate skills. Female medical students tried significantly fewer skills during their clerkship compared to male students. Conclusions: Students believe that skills laboratory training prepare them for their subsequent early clerkship but favour the clerkship over the laboratory

  4. Gynaecological surgical training in the operating room : an exploratory study

    NARCIS (Netherlands)

    van der Houwen, Clasien; Boor, Klarke; Essed, Gerard G. M.; Boendermaker, Peter M.; Scherpbier, Albert A. J. J. A.; Scheele, Fedde

    Objective: One of the challenging goals of gynaecological education is preparing trainees for independent practice of surgery. Research, however, on how to acquire surgical skills in the operating room safely, effectively and efficiently is scarce. We performed this study to explore trainers' and

  5. Social Media in Surgical Training: Opportunities and Risks.

    Science.gov (United States)

    Ovaere, Sander; Zimmerman, David D E; Brady, Richard R

    2018-05-02

    Surgeon engagement with social media is growing rapidly. Innovative applications in diverse fields of health care are increasingly available. The aim of this review is to explore the current and future applications of social media in surgical training. In addition, risks and barriers of social media engagement are analyzed, and recommendations for professional social media use amongst trainers and trainees are suggested. The published, peer-reviewed literature on social media in medicine, surgery and surgical training was reviewed. MESH terms including "social media", "education", "surgical training" and "web applications" were used. Different social media surgical applications are already widely available but limited in use in the trainee's curriculum. E-learning modalities, podcasts, live surgery platforms and microblogs are used for teaching purposes. Social media enables global research collaboratives and can play a role in patient recruitment for clinical trials. The growing importance of networking is emphasized by the increased use of LinkedIn, Facebook, Sermo and other networking platforms. Risks of social media use, such as lack of peer review and the lack of source confirmation, must be considered. Governing surgeon's and trainee's associations should consider adopting and sharing their guidelines for standards of social media use. Surgical training is changing rapidly and as such, social media presents tremendous opportunities for teaching, training, research and networking. Awareness must be raised on the risks of social media use. Copyright © 2018 Association of Program Directors in Surgery. All rights reserved.

  6. Training writing skills: A cognitive development perspective

    Directory of Open Access Journals (Sweden)

    Kellogg, Ronald T.

    2008-01-01

    Full Text Available Writing skills typically develop over a course of more than two decades as a child matures and learns the craft of composition through late adolescence and into early adulthood. The novice writer progresses from a stage of knowledge-telling to a stage of knowledgetransforming characteristic of adult writers. Professional writers advance further to an expert stage of knowledge-crafting in which representations of the author's planned content, the text itself, and the prospective reader's interpretation of the text are routinely manipulated in working memory. Knowledge-transforming, and especially knowledge-crafting, arguably occur only when sufficient executive attention is available to provide a high degree of cognitive control over the maintenance of multiple representations of the text as well as planning conceptual content, generating text, and reviewing content and text. Because executive attention is limited in capacity, such control depends on reducing the working memory demands of these writing processes through maturation and learning. It is suggested that students might best learn writing skills through cognitive apprenticeship training programs that emphasize deliberate practice.

  7. Teaching and Assessing Communication Skills in Medical Undergraduate Training.

    Science.gov (United States)

    Modi, Jyoti Nath; Anshu, -; Chhatwal, Jugesh; Gupta, Piyush; Singh, Tejinder

    2016-06-08

    Good communication skills are essential for an optimal doctor-patient relationship, and also contribute to improved health outcomes. Although the need for training in communication skills is stated as a requirement in the 1997 Graduate Medical Education Regulations of the Medical Council of India, formal training in these skills has been fragmentary and non-uniform in most Indian curricula. The Vision 2015 document of the Medical Council of India reaffirms the need to include training in communication skills in the MBBS curriculum. Training in communication skills needs approaches which are different from that of teaching other clinical subjects. It is also a challenge to ensure that students not only imbibe the nuances of communication and interpersonal skills, but adhere to them throughout their careers. This article addresses the possible ways of standardizing teaching and assessment of communication skills and integrating them into the existing curriculum.

  8. Effective and efficient learning in the operating theater with intraoperative video-enhanced surgical procedure training.

    Science.gov (United States)

    van Det, M J; Meijerink, W J H J; Hoff, C; Middel, B; Pierie, J P E N

    2013-08-01

    INtraoperative Video Enhanced Surgical procedure Training (INVEST) is a new training method designed to improve the transition from basic skills training in a skills lab to procedural training in the operating theater. Traditionally, the master-apprentice model (MAM) is used for procedural training in the operating theater, but this model lacks uniformity and efficiency at the beginning of the learning curve. This study was designed to investigate the effectiveness and efficiency of INVEST compared to MAM. Ten surgical residents with no laparoscopic experience were recruited for a laparoscopic cholecystectomy training curriculum either by the MAM or with INVEST. After a uniform course in basic laparoscopic skills, each trainee performed six cholecystectomies that were digitally recorded. For 14 steps of the procedure, an observer who was blinded for the type of training determined whether the step was performed entirely by the trainee (2 points), partially by the trainee (1 point), or by the supervisor (0 points). Time measurements revealed the total procedure time and the amount of effective procedure time during which the trainee acted as the operating surgeon. Results were compared between both groups. Trainees in the INVEST group were awarded statistically significant more points (115.8 vs. 70.2; p < 0.001) and performed more steps without the interference of the supervisor (46.6 vs. 18.8; p < 0.001). Total procedure time was not lengthened by INVEST, and the part performed by trainees was significantly larger (69.9 vs. 54.1 %; p = 0.004). INVEST enhances effectiveness and training efficiency for procedural training inside the operating theater without compromising operating theater time efficiency.

  9. Paediatric laparoscopic hernia repair: Ex vivo skills in the reduced training era

    Directory of Open Access Journals (Sweden)

    Chris Parsons

    2013-01-01

    Full Text Available Introduction: Changes to surgical working hours have resulted in shorter training times and fewer learning opportunities. Tools that develop surgical skills ex-vivo are of particular interest in this era. Laparoscopic skills are regarded as essential by many for modern paediatric surgery practice. Several generic skills models have been reported and validated. However, there is limited evidence regarding the role of procedure specific models. Here, a laparoscopic paediatric hernia repair model is trialled with surgical trainees and their competence compared with consultant colleagues. Patients and Methods: An ex-vivo paediatric inguinal hernia repair model was devised. Surgical trainees from 5 specialist centres were recruited and performed multiple standardised repairs. Results: 23 trainees performed 192 repairs. Experts performed 10 repairs for comparison. Trainees were timed performing the repair and their accuracy measured. With repeated attempts trainee′s timings and accuracy improved until by the 10 th repair they were no different from benchmark consultant scores. Conclusion: A simple, procedure specific ex-vivo training model has been evaluated for laparoscopic hernia training in paediatric surgery. The results suggest improvements in competence with repetition. Trainee and benchmark consultant scores are no different by the 10 th trainee attempt. We conclude that this model may have a valuable role in the training and assessment of future paediatric surgeons.

  10. The future of patient safety: Surgical trainees accept virtual reality as a new training tool

    Directory of Open Access Journals (Sweden)

    Vogelbach Peter

    2008-06-01

    Full Text Available Abstract Background The use of virtual reality (VR has gained increasing interest to acquire laparoscopic skills outside the operating theatre and thus increasing patients' safety. The aim of this study was to evaluate trainees' acceptance of VR for assessment and training during a skills course and at their institution. Methods All 735 surgical trainees of the International Gastrointestinal Surgery Workshop 2006–2008, held in Davos, Switzerland, were given a minimum of 45 minutes for VR training during the course. Participants' opinion on VR was analyzed with a standardized questionnaire. Results Fivehundred-twenty-seven participants (72% from 28 countries attended the VR sessions and answered the questionnaires. The possibility of using VR at the course was estimated as excellent or good in 68%, useful in 21%, reasonable in 9% and unsuitable or useless in 2%. If such VR simulators were available at their institution, most course participants would train at least one hour per week (46%, two or more hours (42% and only 12% wouldn't use VR. Similarly, 63% of the participants would accept to operate on patients only after VR training and 55% to have VR as part of their assessment. Conclusion Residents accept and appreciate VR simulation for surgical assessment and training. The majority of the trainees are motivated to regularly spend time for VR training if accessible.

  11. Social Skills Training in Correctional Treatment: An Educational Perspective.

    Science.gov (United States)

    Goodrick, David D.; Reed, Thomas

    The authors describe the utilization of psychological methods in training or retraining of prison guards/staff who engaged in an action project with prisoners. Social skills training, behavioral training and effective living approaches are described as they may be integrated into training of persons who work with inmates of correctional…

  12. Performance of Vascular Exposure and Fasciotomy Among Surgical Residents Before and After Training Compared With Experts.

    Science.gov (United States)

    Mackenzie, Colin F; Garofalo, Evan; Puche, Adam; Chen, Hegang; Pugh, Kristy; Shackelford, Stacy; Tisherman, Samuel; Henry, Sharon; Bowyer, Mark W

    2017-06-01

    Surgical patient outcomes are related to surgeon skills. To measure resident surgeon technical and nontechnical skills for trauma core competencies before and after training and up to 18 months later and to compare resident performance with the performance of expert traumatologists. This longitudinal study performed from May 1, 2013, through February 29, 2016, at Maryland State Anatomy Board cadaver laboratories included 40 surgical residents and 10 expert traumatologists. Performance was measured during extremity vascular exposures and lower extremity fasciotomy in fresh cadavers before and after taking the Advanced Surgical Skills for Exposure in Trauma (ASSET) course. The primary outcome variable was individual procedure score (IPS), with secondary outcomes of IPSs on 5 components of technical and nontechnical skills, Global Rating Scale scores, errors, and time to complete the procedure. Two trained evaluators located in the same laboratory evaluated performance with a standardized script and mobile touch-screen data collection. Thirty-eight (95%) of 40 surgical residents (mean [SD] age, 31 [2.9] years) who were evaluated before and within 4 weeks of ASSET training completed follow-up evaluations 12 to 18 months later (mean [SD], 14 [2.7] months). The experts (mean [SD] age, 52 [10.0] years) were significantly older and had a longer (mean [SD], 46 [16.3] months) interval since taking the ASSET course (both P knowledge, correct procedural steps, and decreased errors from 60% to 19% after the ASSET course regardless of clinical year of training (P knowledge (the 2 IPS components most improved with training) indicates the resident's performance was within 1 nearest-neighbor classifier of experts after ASSET training. Five residents had no improvement with training. The Trauma Readiness Index for experts (mean [SD], 74 [4]) was significantly different compared with the trained residents (mean [SD], 48 [7] before training vs 63 [7] after training [P = .004

  13. Mental skills training effectively minimizes operative performance deterioration under stressful conditions: Results of a randomized controlled study.

    Science.gov (United States)

    Anton, N E; Beane, J; Yurco, A M; Howley, L D; Bean, E; Myers, E M; Stefanidis, D

    2018-02-01

    Stress can negatively impact surgical performance, but mental skills may help. We hypothesized that a comprehensive mental skills curriculum (MSC) would minimize resident performance deterioration under stress. Twenty-four residents were stratified then randomized to receive mental skills and FLS training (MSC group), or only FLS training (control group). Laparoscopic suturing skill was assessed on a live porcine model with and without external stressors. Outcomes were compared with t-tests. Twenty-three residents completed the study. The groups were similar at baseline. There were no differences in suturing at posttest or transfer test under normal conditions. Both groups experienced significantly decreased performance when stress was applied, but the MSC group significantly outperformed controls under stress. This MSC enabled residents to perform significantly better than controls in the simulated OR under unexpected stressful conditions. These findings support the use of psychological skills as an integral part of a surgical resident training. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Application of precise training to surgical endoscopic nurses training

    Directory of Open Access Journals (Sweden)

    Zhao Feng

    2017-01-01

    Full Text Available Minimally invasive surgery is an inevitable trend of the development of surgery, the scope of endoscopy surgery application has been covering the whole departments of surgery, which also put forward higher requirements on the nursing coordination during surgery, training high-quality endoscopy nurses is a focus of the researchers. In the paper, the precise training mode was applied to the professional training process of endoscopy nurses, the systematic training of endoscopy nurse was conducted from the following three aspects, including the precision of teaching, the precision of operative cooperation, and the precision of assessment, which had gained good effects. The research indicated that the precise training mode can contribute to upgrading various capacities of endoscopy nurses in the operating room, and improving the teaching quality and effect of specialized training, suggesting a good application effect.

  15. Raven surgical robot training in preparation for da vinci.

    Science.gov (United States)

    Glassman, Deanna; White, Lee; Lewis, Andrew; King, Hawkeye; Clarke, Alicia; Glassman, Thomas; Comstock, Bryan; Hannaford, Blake; Lendvay, Thomas S

    2014-01-01

    The rapid adoption of robotic assisted surgery challenges the pace at which adequate robotic training can occur due to access limitations to the da Vinci robot. Thirty medical students completed a randomized controlled trial evaluating whether the Raven robot could be used as an alternative training tool for the Fundamentals of Laparoscopic Surgery (FLS) block transfer task on the da Vinci robot. Two groups, one trained on the da Vinci and one trained on the Raven, were tested on a criterion FLS block transfer task on the da Vinci. After robotic FLS block transfer proficiency training there was no statistically significant difference between path length (p=0.39) and economy of motion scores (p=0.06) between the two groups, but those trained on the da Vinci did have faster task times (p=0.01). These results provide evidence for the value of using the Raven robot for training prior to using the da Vinci surgical system for similar tasks.

  16. 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.

  17. Preventing Relapse to Cigarette Smoking by Behavioral Skill Training.

    Science.gov (United States)

    Hall, Sharon M.; And Others

    1984-01-01

    Crossed two relapse prevention conditions (skills training-vs-discussion control) with two levels of aversive smoking in volunteer subjects (N=123). Results indicated that relapse-prevention skill training did prevent relapse among cigarette smokers. Lighter smokers were more favorably influenced. (LLL)

  18. Interpersonal Skills Training: Online versus Instructor-Led Courses.

    Science.gov (United States)

    Gilmore, Erika R.; Fritsch, Paula J.

    2001-01-01

    Compares instructional methods used in interpersonal skills training courses delivered online to the methods used in similar courses delivered in a traditional instructor-led classroom. Discusses implications for performance improvement professionals who are responsible for selecting and designing interpersonal skills training interventions.…

  19. Effectiveness of Mobile Learning on Athletic Training Psychomotor Skill Acquisition

    Science.gov (United States)

    Davie, Emily; Martin, Malissa; Cuppett, Micki; Lebsack, Denise

    2015-01-01

    Context: Instruction of psychomotor skills is an important component of athletic training education. Accommodating the varied learning abilities and preferences of athletic training students can be challenging for an instructor initiating skill acquisition in a traditional face-to-face (F2F) environment. Video instruction available on mobile…

  20. Training Verbal and Nonverbal Communication Interview Skills to Adolescents

    Science.gov (United States)

    Olszewski, Abbie; Panorska, Anna; Gillam, Sandra Laing

    2017-01-01

    Adolescents' verbal and nonverbal communication skills were compared before and after training in a workforce readiness training program, Language for Scholars (LFS), and a study skills program, Ideal Student Workshop (ISW). A cross-over design was used, ensuring that 44 adolescents received both programs and acted as their own control. The LFS…

  1. Skills for Employment: Scaling Up Technical and Vocational Training

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

    Many young people have little or no skills. They are excluded from productive economic and social life. Those with an education often have skills that do not match current demand in the labour market, where educational and skill requirements are increasing. Technical and vocational training African countries have put their ...

  2. Efficacy of Social Skills Training in Schizophrenia: A Nursing Review

    LENUS (Irish Health Repository)

    Yadav, B L

    2015-04-07

    Social skills training, a psychological approach, is used to ameliorate the deficits in social skills among patients with a severe mental illness. For the efficacy of social skills training in schizophrenia, the literature in other core psychiatric disciplines (i.e. psychology, psychiatry, etc) indicates some conflicting evidences and a limited quality of evidence in psychiatric nursing. With the exemption of a few individual nursing studies, no systematic review is available to date in psychiatric nursing literature. This systematic review of literature was undertaken to explore the efficacy of social skills training in schizophrenia.

  3. Neuroplasticity-based Cognitive and Linguistic Skills Training Improves Reading and Writing Skills in College Students

    Directory of Open Access Journals (Sweden)

    Beth eRogowsky

    2013-03-01

    Full Text Available This study reports an evaluation of the effect of computer-based cognitive and linguistic training on college students’ reading and writing skills. The computer-based training included a series of increasingly challenging software programs that were designed to strengthen students’ foundational cognitive skills (memory, attention span, processing speed, and sequencing in the context of listening and higher level reading tasks. Twenty-five college students (12 native English language; 13 English Second Language who demonstrated poor writing skills participated in the training group. The training group received daily training during the spring semester (11 weeks with the Fast ForWord Literacy (FFW-L and upper levels of the Fast ForWord Reading series (Levels 3, 4 and 5. The comparison group (n=28 selected from the general college population did not receive training. Both the training and comparison groups attended the same university. All students took the Gates MacGinitie Reading Test (GMRT and the Oral and Written Language Scales (OWLS Written Expression Scale at the beginning (Time 1 and end (Time 2 of the spring college semester. Results from this study showed that the training group made a statistically greater improvement from Time 1 to Time 2 in both their reading skills and their writing skills than the comparison group. The group who received training began with statistically lower writing skills before training, but exceeded the writing skills of the comparison group after training.

  4. Developing communication skills training in 5 educational programs

    DEFF Research Database (Denmark)

    Nielsen, Annegrethe; Ringby, Betina

    Understanding the ability to communicate with patients as a central clinical skill, the importance of developing communication teaching in healthcare educations is obvious. Following the establishment of a room specially equipped for training communication skills in 2010, implementation of commun......Understanding the ability to communicate with patients as a central clinical skill, the importance of developing communication teaching in healthcare educations is obvious. Following the establishment of a room specially equipped for training communication skills in 2010, implementation....... As a result of the combination of easy access to technical resources in the dedicated room and the opportunity to continuously develop the facilitation skills needed to train students, communication skills training has been integrated in the curriculum of all five healthcare educational programmes....

  5. 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.

  6. The future of innovation and training in surgical oncology.

    Science.gov (United States)

    Kim, Michael J; Monson, John R T

    2011-09-01

    This article addresses the current paradigms of surgical oncology training and the directions in which the training process may evolve over the course of the next decade. In doing so, the potential influences upon this evolution are discussed along with potential barriers associated with each of these factors. In particular, the topics include issues of specialty training with regard to new technologies and procedures, involvement of the surgeon as part of the multi-disciplinary team of oncologists, and the very real issue of burnout and career satisfaction associated with the profession of surgical oncology. Changes to the training of tomorrow's cancer surgeons will need to involve each one of these factors in a comprehensive and efficient manner, in order to ensure the continued strength and growth of the field. Copyright © 2010 Elsevier Ltd. All rights reserved.

  7. From dV-Trainer to Real Robotic Console: The Limitations of Robotic Skill Training.

    Science.gov (United States)

    Yang, Kun; Zhen, Hang; Hubert, Nicolas; Perez, Manuela; Wang, Xing Huan; Hubert, Jacques

    To investigate operators' performance quality, mental stress, and ergonomic habits through a training curriculum on robotic simulators. Forty volunteers without robotic surgery experience were recruited to practice 2 exercises on a dV-Trainer (dVT) for 14 hours. The simulator software (M-score a ) provided an automatic evaluation of the overall score for the surgeons' performance. Each participant provided a subjective difficulty score (validity to be proven) for each exercise. Their ergonomic habits were evaluated based on the workspace range and armrest load-validated criteria for evaluating the proficiency of using the armrest. They then repeated the same tasks on a da Vinci Surgical Skill Simulator for a final-level test. Their final scores were compared with their initial scores and the scores of 5 experts on the da Vinci Surgical Skill Simulator. A total of 14 hours of training on the dVT significantly improved the surgeons' performance scores to the expert level with a significantly reduced workload, but their ergonomic score was still far from the expert level. Sufficient training on the dVT improves novices' performance, reduces psychological stress, and inculcates better ergonomic habits. Among the evaluated criteria, novices had the most difficulty in achieving expert levels of ergonomic skills. The training benefits of robotic surgery simulators should be determined with quantified variables. The detection of the limitations during robotic training curricula could guide the targeted training and improve the training effect. Copyright © 2017. Published by Elsevier Inc.

  8. 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

    area for the combined procedure was 0.938 for OSATS video score and 0.799 for simulator score (P=0.072.Conclusion: Video-based scoring of the phacoemulsification procedure was superior to the innate simulator scoring system in distinguishing cataract surgical skills. Simulator scoring rendered unacceptably poor discrimination for both the hydromaneuvers and the phacoemulsification divide-and-conquer module. Our results indicate a potential for improvement in Eyesi internal computer-based scoring.Keywords: simulator, training, cataract surgery, ROC, virtual reality

  9. 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.

  10. A Descriptive Analysis of the Use of Workplace-Based Assessments in UK Surgical Training.

    Science.gov (United States)

    Shalhoub, Joseph; Santos, Cristel; Bussey, Maria; Eardley, Ian; Allum, William

    2015-01-01

    Workplace-based assessments (WBAs) were introduced formally in the UK in 2007. The aim of the study was to describe the use of WBAs by UK surgical trainees and examine variations by training region, specialty, and level of training. The database of the Intercollegiate Surgical Curriculum Programme was examined for WBAs between August 2007 and July 2013, with in-depth analysis of 2 periods: August 2011 to July 2012 and August 2012 to July 2013. The numbers of validated WBAs per trainee per year increased more than 7-fold, from median 6 per trainee in 2007 to 2008, to 39 in 2011 to 2012, and 44 in 2012 to 2013. In the period 2011 to 2012, 58.4% of core trainees completed the recommended 40 WBAs, with only 38.1% of specialty trainees achieving 40 validated WBAs. In the period 2012 to 2013, these proportions increased to 67.7% and 57.0% for core and specialty trainees, respectively. Core trainees completed more WBAs per year than specialty trainees in the same training region. London core trainees completed the highest numbers of WBAs in both the periods 2011 to 2012 (median 67) and 2012 to 2013 (median 74). There was a peak in WBAs completed by London specialty trainees in the period 2012 to 2013 (median 63). The most validated WBAs were completed by ST1/CT1 (specialty surgical training year, core surgical training year), with a gradual decrease in median WBAs to ST4, followed by a plateau; in the period 2012 to 2013, there was an increase in WBAs at ST8. Core surgical trainees complete ~50% "operative" (procedure-based assessment/direct observation of procedural skills) and ~50% "nonoperative" assessments (case-based discussion/clinical evaluation exercise). During specialty training, procedure-based assessments represented ~46% of WBAs, direct observation of procedural skills 11.2%, case-based discussion ~23%, and clinical evaluation exercise ~15%. UK surgical trainees are, on an average, undertaking 1 WBA per week. Variation exists in use of WBAs between training

  11. Systematic evaluation of nuclear operator team skills training

    International Nuclear Information System (INIS)

    Harrington, D.K.; Kello, J.E.

    1991-01-01

    In recent years, the nuclear industry has increasingly recognized with the technical training given its control room operators. As yet, however, little has been done to determine the actual effectiveness of such nontechnical training. Thus, the questions of how team training should be carried out for maximum impact on the safety and efficiency of control room operation and just what the benefits of such training might be remain open. We are in the early stages of establishing a systematic evaluation process that will help nuclear utilities assess the effectiveness of their existing team skills training programs for control room operators. Research focuses on defining the specific behavioral and attitudinal objectives of team skills training. Simply put, what does good practice look like and sound like in the control room environment? What specific behaviors and attitudes should the training be directed toward? Obviously, the answers to the questions have clear implications for the design of nuclear team skills training programs

  12. Trained, generalized, and collateral behavior changes of preschool children receiving gross-motor skills training.

    OpenAIRE

    Kirby, K C; Holborn, S W

    1986-01-01

    Three preschool children participated in a behavioral training program to improve their gross-motor skills. Ten target behaviors were measured in the training setting to assess direct effects of the program. Generalization probes for two gross-motor behaviors, one fine-motor skill, and two social behaviors were conducted in other settings. Results indicated that the training program improved the gross-motor skills trained and that improvements sometimes generalized to other settings. Contrary...

  13. Evaluation of Augmented Reality Feedback in Surgical Training Environment.

    Science.gov (United States)

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

    2018-02-01

    Providing computer-based laparoscopic surgical training has several advantages that enhance the training process. Self-evaluation and real-time performance feedback are 2 of these advantages, which avoid dependency of trainees on expert feedback. The goal of this study was to investigate the use of a visual time indicator as real-time feedback correlated with the laparoscopic surgical training. Twenty novices participated in this study working with (and without) different presentations of time indicators. They performed a standard peg transfer task, and their completion times and muscle activity were recorded and compared. Also of interest was whether the use of this type of feedback induced any side effect in terms of motivation or muscle fatigue. Of the 20 participants, 15 (75%) preferred using a time indicator in the training process rather than having no feedback. However, time to task completion showed no significant difference in performance with the time indicator; furthermore, no significant differences in muscle activity or muscle fatigue were detected with/without time feedback. The absence of significant difference between task performance with/without time feedback shows that using visual real-time feedback can be included in surgical training based on user preference. Trainees may benefit from this type of feedback in the form of increased motivation. The extent to which this can influence training frequency leading to performance improvement is a question for further study.

  14. Simulation-based ureteroscopy skills training curriculum with integration of technical and non-technical skills: a randomised controlled trial.

    Science.gov (United States)

    Brunckhorst, Oliver; Shahid, Shahab; Aydin, Abdullatif; McIlhenny, Craig; Khan, Shahid; Raza, Syed Johar; Sahai, Arun; Brewin, James; Bello, Fernando; Kneebone, Roger; Khan, Muhammad Shamim; Dasgupta, Prokar; Ahmed, Kamran

    2015-09-01

    Current training modalities within ureteroscopy have been extensively validated and must now be integrated within a comprehensive curriculum. Additionally, non-technical skills often cause surgical error and little research has been conducted to combine this with technical skills teaching. This study therefore aimed to develop and validate a curriculum for semi-rigid ureteroscopy, integrating both technical and non-technical skills teaching within the programme. Delphi methodology was utilised for curriculum development and content validation, with a randomised trial then conducted (n = 32) for curriculum evaluation. The developed curriculum consisted of four modules; initially developing basic technical skills and subsequently integrating non-technical skills teaching. Sixteen participants underwent the simulation-based curriculum and were subsequently assessed, together with the control cohort (n = 16) within a full immersion environment. Both technical (Time to completion, OSATS and a task specific checklist) and non-technical (NOTSS) outcome measures were recorded with parametric and non-parametric analyses used depending on the distribution of our data as evaluated by a Shapiro-Wilk test. Improvements within the intervention cohort demonstrated educational value across all technical and non-technical parameters recorded, including time to completion (p technical and non-technical skills teaching is both educationally valuable and feasible. Additionally, the curriculum offers a validated simulation-based training modality within ureteroscopy and a framework for the development of other simulation-based programmes.

  15. 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

  16. Robotic technologies in surgical oncology training and practice.

    Science.gov (United States)

    Orvieto, Marcelo A; Marchetti, Pablo; Castillo, Octavio A; Coelho, Rafael F; Chauhan, Sanket; Rocco, Bernardo; Ardila, Bobby; Mathe, Mary; Patel, Vipul R

    2011-09-01

    The modern-day surgeon is frequently exposed to new technologies and instrumentation. Robotic surgery (RS) has evolved as a minimally invasive technique aimed to improve clinical outcomes. RS has the potential to alleviate the inherent limitations of laparoscopic surgery such as two dimensional imaging, limited instrument movement and intrinsic human tremor. Since the first reported robot-assisted surgical procedure performed in 1985, the technology has dramatically evolved and currently multiple surgical specialties have incorporated RS into their daily clinical armamentarium. With this exponential growth, it should not come as a surprise the ever growing requirement for surgeons trained in RS as well as the interest from residents to receive robotic exposure during their training. For this reason, the establishment of set criteria for adequate and standardized training and credentialing of surgical residents, fellows and those trained surgeons wishing to perform RS has become a priority. In this rapidly evolving field, we herein review the past, present and future of robotic technologies and its penetration into different surgical specialties. Copyright © 2010 Elsevier Ltd. All rights reserved.

  17. Leaving surgical training: some of the reasons are in surgery.

    Science.gov (United States)

    Forel, Deanne; Vandepeer, Meegan; Duncan, Joanna; Tivey, David R; Tobin, Stephen A

    2018-05-01

    In 2014, the Royal Australasian College of Surgeons identified, through internal analysis, a considerable attrition rate within its Surgical Education and Training programme. Within the attrition cohort, choosing to leave accounted for the majority. Women were significantly over-represented. It was considered important to study these 'leavers' if possible. An external group with medical education expertise were engaged to do this, a report that is now published and titled 'A study exploring the reasons for and experiences of leaving surgical training'. During this time, the Royal Australasian College of Surgeons came under serious external review, leading to the development of the Action Plan on Discrimination, Bullying and Sexual Harassment in the Practice of Surgery, known as the Building Respect, Improving Patient Safety (BRIPS) action plan. The 'Leaving Training Report', which involved nearly one-half of all voluntary 'leavers', identified three major themes that were pertinent to leaving surgical training. Of these, one was about surgery itself: the complexity, the technical, decision-making and lifestyle demands, the emotional aspects of dealing with seriously sick patients and the personal toll of all of this. This narrative literature review investigates these aspects of surgical education from the trainees' perspective. © 2018 Royal Australasian College of Surgeons.

  18. Laparoscopy training in surgical education: the utility of incorporating a structured preclinical laparoscopy course into the traditional apprenticeship method.

    Science.gov (United States)

    De Win, Gunter; Van Bruwaene, Siska; Aggarwal, Rajesh; Crea, Nicola; Zhang, Zhewen; De Ridder, Dirk; Miserez, Marc

    2013-01-01

    To investigate whether preclinical laparoscopy training offers a benefit over standard apprenticeship training and apprenticeship training in combination with simulation training. This randomized controlled trial consisted of 3 groups of first-year surgical registrars receiving a different teaching method in laparoscopic surgery. The KU LEUVEN Faculty of Medicine is the largest medical faculty in Belgium. Thirty final-year medical students starting a general surgical career in the next academic year. Thirty final-year medical students were randomized into 3 groups, which differed in the way they were exposed to laparoscopic simulation training but were comparable in regard to ambidexterity, sex, age, and laparoscopic psychomotoric skills. The control group received only clinical training during surgical residentship, whereas the interval group received clinical training in combination with simulation training. The registrars were allowed to do deliberate practice. The Centre for Surgical Technologies Preclinical Training Programme (CST PTP) group received a preclinical simulation course during the final year as medical students, but was not exposed to any extra simulation training during surgical residentship. At the beginning of surgical residentship and 6 months later, all subjects performed a standardized suturing task and a laparoscopic cholecystectomy in a POP Trainer. All procedures were recorded together with time and motion tracking parameters. All videos were scored by a blinded observer using global rating scales. At baseline the 3 groups were comparable. At 6 months, for suturing, the CST PTP group was better than both the other groups with respect to time, checklist, and amount of movements. The interval group was better than the control group on only the time and checklist score. For the cholecystectomy evaluation, there was a statistical difference between the CST PTP study group and both other groups on all evaluation scales in favor of the CST PTP

  19. Computer-Based Training Methods for Surgical Training

    Science.gov (United States)

    2009-10-07

    said surgical procedure. 32. The rm:thod of daim 30. whcn.:in st~id linul dm ;~.:­ dimcnsional model is used to evaluate pcrKwmancc charac...of Environmental Aging Upon the Load Bearing Properties and Polyurethane Foams. Noble PC; Goode B; Krouskop TA; and Crisp B. Journal Rehab. Res. and...Surgery 77A: 513-523, 1995. 32. Partial Tears of the Anterior Cruciate Ligament. Are They Clinically Detectable? Lintner DM , Kamaric E, Moseley JB

  20. Coding Bootcamps : Building Future-Proof Skills through Rapid Skills Training

    OpenAIRE

    World Bank

    2017-01-01

    This report studies coding bootcamps. A new kind of rapid skills training program for the digital age. Coding bootcamps are typically short-term (three to six months), intensive and applied training courses provided by a third party that crowdsources the demand for low-skills tech talent. Coding bootcamps aim at low-entry level tech employability (for example, junior developer), providing a ...

  1. Self-Monitoring and Counseling Skills Skills-Based Versus Interpersonal Process Recall Training

    Science.gov (United States)

    Crews, Judith; Smith, Michael R.; Smaby, Marlowe H.; Maddux, Cleborne D.; Torres-Rivera, Edil; Casey, John A.; Urbani, Steve

    2005-01-01

    The purpose of this study was to investigate the role of personality traits of counselors-in-training with regard to counseling performance. There were no differences in pretest or posttest scores on the Skilled Counseling Scale (SCS) of high and low self-monitoring counselors-in-training. Skill attainment may have more effect on personality…

  2. Integration of Hands-On Team Training into Existing Curriculum Improves Both Technical and Nontechnical Skills in Laparoscopic Cholecystectomy.

    Science.gov (United States)

    Caskey, Robert C; Owei, Lily; Rao, Raghavendra; Riddle, Elijah W; Brooks, Ari D; Dempsey, Daniel T; Morris, Jon B; Neylan, Christopher J; Williams, Noel N; Dumon, Kristoffel R

    Nontechnical skills are an essential component of surgical education and a major competency assessed by the ACGME milestones project. However, the optimal way to integrate nontechnical skills training into existing curricula and then objectively evaluate the outcome is still unknown. The aim of this study was to determine the effect laparoscopic team-based task training would have on the nontechnical skills needed for laparoscopic surgery. 9 PGY-1 residents underwent an established training curriculum for teaching the knowledge and technical skills involved in laparoscopic cholecystectomy. Initial training involved a didactic session, expert-led practice on a porcine model in a simulated operating room and laparoscopic skills practice on a virtual reality trainer. Residents then performed a laparoscopic cholecystectomy on the same porcine model as a preintervention test. Three to four months following this, residents were subjected to specific nontechnical skills training involving 2 simple team-based laparoscopic tasks. They then practiced a further 4 to 6 hours on the virtual reality trainer. A repeat postintervention laparoscopic cholecystectomy was then performed 3 to 4 months after nontechnical skills training. Both the preintervention and postintervention laparoscopic cholecystectomies were audiovisually recorded and then evaluated by 2 independent surgeons in a blinded fashion. Technical skills were assessed using objective structured assessment of technical skills (OSATS) and a technique specific rating scale (TRS) that we developed for laparoscopic cholecystectomy. Nontechnical skills were assessed using nontechnical skills for surgeons (NOTSS). Residents also completed a survey at the beginning and end of the training. Tertiary care, university based teaching institution. A total of 9 general surgery residents at the intern level. The mean OSATS score improved from 13.7 ± 1.24 to 26.7 ± 0.31 (p training. There was a strong correlation between OSATS and

  3. The Effect of Social Skills Training on Socialization Skills in Children with Down Syndrome

    Directory of Open Access Journals (Sweden)

    Hajar Barati

    2012-04-01

    Full Text Available Objectives: The development of social skills, especially skills in relating to peers, is an important capacity that provides the foundations for lifelong success. Some children with disabilities need to learn social skills more directly. The purpose of this study was to determine the effects of social skills training on socialization skills development in children with Down syndrome. Methods: This study was a semi-experimental conducted on thirty-seven student with Down syndrome, 8-12 years old with IQ 55–75. Subjects were divided randomly in two groups (n=18 and control group (n=19. Initially, each of the subjects was assessed by the list of social skills, and then social skill training was performed for 60 minutes, two times weekly, for two months in intervention group, and the socialization skills was evaluated after intervention and 2 months later in the two groups. Results: A significant (P<0.05 improvement in socialization skills was occurred. Follow-up study also showed, improvement of socialization skills were maintained 2 months after the end of training in intervention group (P<0.05. Discussion: It’s seems that training of social skills can improve the socialization skills of children with Down's syndrome.

  4. Teamwork, Soft Skills, and Research Training.

    Science.gov (United States)

    Gibert, Anaïs; Tozer, Wade C; Westoby, Mark

    2017-02-01

    We provide a list of soft skills that are important for collaboration and teamwork, based on our own experience and from an opinion survey of team leaders. Each skill can be learned to some extent. We also outline workable short courses for graduate schools to strengthen teamwork and collaboration skills among research students. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Nordic Pharmacy Schools’ Experience in Communication Skills Training

    Science.gov (United States)

    Björnsdottir, Ingunn; Wallman, Andy; Sporrong, Sofia Kälvemark

    2017-01-01

    Objective. To assess communication skills training at Nordic pharmacy schools and explore ways for improvement. Methods. E-mail questionnaires were developed and distributed with the aim to explore current practice and course leaders’ opinions regarding teaching of patient communication skills at all the 11 master level Nordic (Denmark, Finland, Iceland, Norway and Sweden) pharmacy schools. The questionnaires contained both closed- and open-ended questions. Results. There was a variation of patient communication skills training among schools. In general, communication skills training was included in one to five courses (mode 1); varied in quantity (6-92 hours); had low use of experiential training methods; and had challenges regarding assessments and acquiring sufficient resources. However, some schools had more focus on such training. Conclusion. The results show room for improvement in patient communication skills training in most Nordic pharmacy schools and give insights into how to enhance communication skill building in pharmacy curricula. Suggestions for improving the training include: early training start, evidence-based frameworks, experiential training, and scaffolding. PMID:29302085

  6. Private sector surgical training: feasibility through the lens of appendicectomy.

    Science.gov (United States)

    Yap, Raymond; Cullinan, Mark

    2017-12-01

    Training in medicine and surgery has been a public hospital responsibility in Australia. Increasing specialist training needs has led to pressure on speciality societies to find additional training posts, with one utilized solution being the establishment of private hospital training. This growing use has been despite no previously published evaluations of private hospital training in Australia. This article seeks to evaluate the feasibility of surgical training in private hospitals in appendicectomy. Data were prospectively collected on registrar involvement in appendicectomy cases at a single private tertiary institution over 1 year. These data were divided into groups according to registrar involvement and analysed, looking at training caseload, operating theatre time and complications. A total of 122 cases were analysed over the study period. Registrars were more likely to have increased primary operator responsibility if they were an accredited versus unaccredited registrar (P = 0.04) and if the case was open versus laparoscopic (P difference in complications whether the registrar was involved or not. Training in the private sector in Australia appears feasible, with a small loss of efficiency and no increase in complications. This article hopes to further encourage implementation and evaluation of private sector training programs to expand current training positions. Further studies, in different specialty and procedural domains, are needed to assess and evaluate the ongoing feasibility of private sector training. © 2016 Royal Australasian College of Surgeons.

  7. 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.

  8. Nursing students' perceptions of soft skills training in Ghana.

    Science.gov (United States)

    Laari, Luke; Dube, Barbara M

    2017-09-22

    The quality of nursing care rendered today is markedly reducing and the amount of time spent with patients listening to and explaining issues concerning their conditions is gradually diminishing. The therapeutic touch and the listening ear of the nurse are no longer accessible to the patient. Understanding what non-technical skills are and their relevance for healthcare practitioners has become a new area of consideration. Although recent literature has highlighted the necessity of introducing soft skills training and assessment within medical education, nursing education is yet to fully embrace this skills training. The aim of this study was to explore nursing students' understanding of the concept of soft skills and to acquire their perception on the need for soft skills training to promote quality nursing care. A quantitative research design with descriptive and explorative strategies was used. One hundred and ten nursing students were sampled after permission to conduct the study was requested and obtained from the University of KwaZulu-Natal Ethics Committee. The results indicated that a majority (68.8%) of respondents understood the concept of soft skills and agreed with the definition of 'soft skills'. They furthermore agreed that soft skills should be part of the training that student nurses receive during their professional training. The study revealed that there is a need for nursing students to be educated in soft skills and that this will enhance their job performances in the clinical environment and improve the way in which they communicate with their clients.

  9. Basic visual observation skills training course. Final report

    International Nuclear Information System (INIS)

    Toquam, J.L.; Morris, F.A.; Griggs, J.R.

    1995-06-01

    This is the third report in a series prepared to assist the International Atomic Energy Agency (IAEA or Agency) in enhancing the effectiveness of its international safeguards inspections through inspector training in Observation Skills. The first report (Phase 1) was essentially exploratory. It defined Observation Skills' broadly to include all appropriate cognitive, communications, and interpersonal techniques that have the potential to help IAEA safeguards inspectors function more effectively. The second report (Phase 2) provided a more specific basis for the actual design and delivery of Observation Skills training to IAEA inspectors. The present report (Phase 3) documents the design of a Basic Visual Observation Skills course and delivery of the course to safeguards inspectors at IAEA Headquarters Vienna in February and May of 1995. The purpose of the course is to help safeguards inspectors evaluate and improve their skills in making observations during inspections and in evaluating and interpreting this information. The course is basic in the sense that it provides training in skills which are generally applicable to inspections of all types of facilities and activities subject to safeguards. The course is designed for 16 hours of classroom delivery, ideally in four 4-hour sessions over a period of four days. The first 12 hours provide training in five skill areas: perception and recognition; attention and attention to detail; memory; mental imaging, mapping, and modeling skills; and judgment and decision making. Following the training in each of the five skill areas is an Integrating Exercise involving a simulated safeguards inspection

  10. Practical Clinical Training in Skills Labs: Theory and Practice

    Directory of Open Access Journals (Sweden)

    Bugaj, T. J.

    2016-08-01

    Full Text Available Today, skills laboratories or “skills labs”, i.e. specific practical skill training facilities, are a firmly established part of medical education offering the possibility of training clinical procedures in a safe and fault-forging environment prior to real life application at bedside or in the operating room. Skills lab training follows a structured teaching concept, takes place under supervision and in consideration of methodological-didactic concepts, ideally creating an atmosphere that allows the repeated, anxiety- and risk-free practice of targeted skills.In this selective literature review, the first section is devoted to (I the development and dissemination of the skills lab concept. There follows (II an outline of the underlying idea and (III an analysis of key efficacy factors. Thereafter, (IV the training method’s effectiveness and transference are illuminated, before (V the use of student tutors, in the sense of peer-assisted-learning, in skills labs is discussed separately. Finally, (VI the efficiency of the skills lab concept is analyzed, followed by an outlook on future developments and trends in the field of skills lab training.

  11. 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

  12. Facilitating the implementation of the American College of Surgeons/Association of Program Directors in Surgery phase III skills curriculum: training faculty in the assessment of team skills.

    Science.gov (United States)

    Hull, Louise; Arora, Sonal; Stefanidis, Dimitrios; Sevdalis, Nick

    2015-11-01

    Effective teamwork is critical to safety in the operating room; however, implementation of phase III of the American College of Surgeons (ACS) and Association of Program Directors in Surgery (APDS) Curriculum that focuses on team-based skills remains worryingly low. Training and assessing the complexities of teamwork is challenging. The objective of this study was to establish guidelines and recommendations for training faculty in assessing/debriefing team skills. A multistage survey-based consensus study was completed by 108 experts responsible for training and assessing surgical residents from the ACS Accredited Educational Institutes. Experts agreed that a program to teach faculty to assess team-based skills should include training in the recognition of teamwork skills, practice rating these skills, and training in the provision of feedback/debriefing. Agreement was reached that faculty responsible for conducting team-based skills assessment should be revalidated every 2 years and stringent proficiency criteria should be met. Faculty development is critical to ensure high-quality, standardized training and assessment. Training faculty to assess team-based skills has the potential to facilitate the effective implementation of phase III of the ACS and APDS Curriculum. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Development and implementation of plant diagnostic skills training

    International Nuclear Information System (INIS)

    Iwatare, K.; Noji, K.

    2010-01-01

    It was learned from the July 2007 Chuetsu-oki Earthquake that a need exists for simulator training methods to be revised to include the assumption of multiple failures such as those which may occur during a large earthquake. At BWR Operator Training Center Corp., multiple failure team training which focuses on plant diagnostic skills (Plant Diagnostic Skills Training) has been developed and implemented since September 2008. The contents of this training along with the results are presented and considered in this paper. (author)

  14. Effects of Skill Training on Working Memory Capacity

    Science.gov (United States)

    Lee, Yuh-shiow; Lu, Min-ju; Ko, Hsiu-ping

    2007-01-01

    In this study we examined the effects of skill training, in particular mental abacus and music training, on working memory. Two groups of participants--children who had received mental abacus training and their controls--participated in Experiment 1. All participants performed the following span tasks: forward digit span, backward digit span,…

  15. Helping While Learning: A Skilled Group Helper Training Program.

    Science.gov (United States)

    Smaby, Marlowe H.; Tamminen, Armas W.

    1983-01-01

    Describes a developmental group training workshop for training experienced counselors to do group counseling. Discusses stages of training including exploration, understanding, and action, which can help counselors learn helping skills for counseling that can often transfer to their own interpersonal lives and interactions with others. (JAC)

  16. Perceptions of Employees and Supervisors of a Skills Training Program

    Science.gov (United States)

    Calcavecchi, Lincoln Todd

    2018-01-01

    Organizational leaders know that training improves worker performance, but training is often initiated without considering employees' work task requirements. This instrumental case study was conducted to understand the perceptions of employees who completed a skills training program and those of supervisors. The conceptual framework was andragogy,…

  17. Role-playing for more realistic technical skills training.

    Science.gov (United States)

    Nikendei, C; Zeuch, A; Dieckmann, P; Roth, C; Schäfer, S; Völkl, M; Schellberg, D; Herzog, W; Jünger, J

    2005-03-01

    Clinical skills are an important and necessary part of clinical competence. Simulation plays an important role in many fields of medical education. Although role-playing is common in communication training, there are no reports about the use of student role-plays in the training of technical clinical skills. This article describes an educational intervention with analysis of pre- and post-intervention self-selected student survey evaluations. After one term of skills training, a thorough evaluation showed that the skills-lab training did not seem very realistic nor was it very demanding for trainees. To create a more realistic training situation and to enhance students' involvement, case studies and role-plays with defined roles for students (i.e. intern, senior consultant) were introduced into half of the sessions. Results of the evaluation in the second term showed that sessions with role-playing were rated significantly higher than sessions without role-playing.

  18. Evaluating veterinary practitioner perceptions of communication skills and training.

    Science.gov (United States)

    McDermott, M P; Cobb, M A; Tischler, V A; Robbé, I J; Dean, R S

    2017-03-25

    A survey was conducted among veterinary practitioners in the UK and the USA in 2012/2013. Thematic analysis was used to identify underlying reasons behind answers to questions about the importance of communication skills and the desire to participate in postgraduate communication skills training. Lack of training among more experienced veterinary surgeons, incomplete preparation of younger practitioners and differences in ability to communicate all contribute to gaps in communication competency. Barriers to participating in further communication training include time, cost and doubts in the ability of training to provide value. To help enhance communication ability, communication skills should be assessed in veterinary school applicants, and communication skills training should be more thoroughly integrated into veterinary curricula. Continuing education/professional development in communication should be part of all postgraduate education and should be targeted to learning style preferences and communication needs and challenges through an entire career in practice. British Veterinary Association.

  19. Technical tips and advancements in pediatric minimally invasive surgical training on porcine based simulations.

    Science.gov (United States)

    Narayanan, Sarath Kumar; Cohen, Ralph Clinton; Shun, Albert

    2014-06-01

    Minimal access techniques have transformed the way pediatric surgery is practiced. Due to various constraints, surgical residency programs have not been able to tutor adequate training skills in the routine setting. The advent of new technology and methods in minimally invasive surgery (MIS), has similarly contributed to the need for systematic skills' training in a safe, simulated environment. To enable the training of the proper technique among pediatric surgery trainees, we have advanced a porcine non-survival model for endoscopic surgery. The technical advancements over the past 3 years and a subjective validation of the porcine model from 114 participating trainees using a standard questionnaire and a 5-point Likert scale have been described here. Mean attitude scores and analysis of variance (ANOVA) were used for statistical analysis of the data. Almost all trainees agreed or strongly agreed that the animal-based model was appropriate (98.35%) and also acknowledged that such workshops provided adequate practical experience before attempting on human subjects (96.6%). Mean attitude score for respondents was 19.08 (SD 3.4, range 4-20). Attitude scores showed no statistical association with years of experience or the level of seniority, indicating a positive attitude among all groups of respondents. Structured porcine-based MIS training should be an integral part of skill acquisition for pediatric surgery trainees and the experience gained can be transferred into clinical practice. We advocate that laparoscopic training should begin in a controlled workshop setting before procedures are attempted on human patients.

  20. Selection for Surgical Training: An Evidence-Based Review.

    Science.gov (United States)

    Schaverien, Mark V

    2016-01-01

    The predictive relationship between candidate selection criteria for surgical training programs and future performance during and at the completion of training has been investigated for several surgical specialties, however there is no interspecialty agreement regarding which selection criteria should be used. Better understanding the predictive reliability between factors at selection and future performance may help to optimize the process and lead to greater standardization of the surgical selection process. PubMed and Ovid MEDLINE databases were searched. Over 560 potentially relevant publications were identified using the search strategy and screened using the Cochrane Collaboration Data Extraction and Assessment Template. 57 studies met the inclusion criteria. Several selection criteria used in the traditional selection demonstrated inconsistent correlation with subsequent performance during and at the end of surgical training. The following selection criteria, however, demonstrated good predictive relationships with subsequent resident performance: USMLE examination scores, Letters of Recommendation (LOR) including the Medical Student Performance Evaluation (MSPE), academic performance during clinical clerkships, the interview process, displaying excellence in extracurricular activities, and the use of unadjusted rank lists. This systematic review supports that the current selection process needs to be further evaluated and improved. Multicenter studies using standardized outcome measures of success are now required to improve the reliability of the selection process to select the best trainees. Published by Elsevier Inc.

  1. Training for Skill in Fault Diagnosis

    Science.gov (United States)

    Turner, J. D.

    1974-01-01

    The Knitting, Lace and Net Industry Training Board has developed a training innovation called fault diagnosis training. The entire training process concentrates on teaching based on the experiences of troubleshooters or any other employees whose main tasks involve fault diagnosis and rectification. (Author/DS)

  2. Mental skills training with basic combat training soldiers: A group-randomized trial.

    Science.gov (United States)

    Adler, Amy B; Bliese, Paul D; Pickering, Michael A; Hammermeister, Jon; Williams, Jason; Harada, Coreen; Csoka, Louis; Holliday, Bernie; Ohlson, Carl

    2015-11-01

    Cognitive skills training has been linked to greater skills, self-efficacy, and performance. Although research in a variety of organizational settings has demonstrated training efficacy, few studies have assessed cognitive skills training using rigorous, longitudinal, randomized trials with active controls. The present study examined cognitive skills training in a high-risk occupation by randomizing 48 platoons (N = 2,432 soldiers) in basic combat training to either (a) mental skills training or (b) an active comparison condition (military history). Surveys were conducted at baseline and 3 times across the 10-week course. Multilevel mixed-effects models revealed that soldiers in the mental skills training condition reported greater use of a range of cognitive skills and increased confidence relative to those in the control condition. Soldiers in the mental skills training condition also performed better on obstacle course events, rappelling, physical fitness, and initial weapons qualification scores, although effects were generally moderated by gender and previous experience. Overall, effects were small; however, given the rigor of the design, the findings clearly contribute to the broader literature by providing supporting evidence that cognitive training skills can enhance performance in occupational and sports settings. Future research should address gender and experience to determine the need for targeting such training appropriately. (c) 2015 APA, all rights reserved).

  3. 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

  4. Recommended observational skills training for IAEA safeguards inspections. Final report: Recommended observational skills training for IAEA safeguards inspections

    International Nuclear Information System (INIS)

    Toquam, J.L.; Morris, F.A.

    1994-09-01

    This is the second of two reports prepared to assist the International Atomic Energy Agency (IAEA or Agency) in enhancing the effectiveness of its international safeguards inspections through inspector training in open-quotes Observational Skillsclose quotes. The first (Phase 1) report was essentially exploratory. It defined Observational Skills broadly to include all appropriate cognitive, communications, and interpersonal techniques that have the potential to help IAEA safeguards inspectors function more effectively. It identified 10 specific Observational Skills components, analyzed their relevance to IAEA safeguards inspections, and reviewed a variety of inspection programs in the public and private sectors that provide training in one or more of these components. The report concluded that while it should be possible to draw upon these other programs in developing Observational Skills training for IAEA inspectors, the approaches utilized in these programs will likely require significant adaption to support the specific job requirements, policies, and practices that define the IAEA inspector's job. The overall objective of this second (Phase 2) report is to provide a basis for the actual design and delivery of Observational Skills training to IAEA inspectors. The more specific purposes of this report are to convey a fuller understanding of the potential application of Observational Skills to the inspector's job, describe inspector perspectives on the relevance and importance of particular Observational Skills, identify the specific Observational Skill components that are most important and relevant to enhancing safeguards inspections, and make recommendations as to Observational Skills training for the IAEA's consideration in further developing its Safeguards training program

  5. Assessment methods in surgical training in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Evgenios Evgeniou

    2013-02-01

    Full Text Available A career in surgery in the United Kingdom demands a commitment to a long journey of assessment. The assessment methods used must ensure that the appropriate candidates are selected into a programme of study or a job and must guarantee public safety by regulating the progression of surgical trainees and the certification of trained surgeons. This review attempts to analyse the psychometric properties of various assessment methods used in the selection of candidates to medical school, job selection, progression in training, and certification. Validity is an indicator of how well an assessment measures what it is designed to measure. Reliability informs us whether a test is consistent in its outcome by measuring the reproducibility and discriminating ability of the test. In the long journey of assessment in surgical training, the same assessment formats are frequently being used for selection into a programme of study, job selection, progression, and certification. Although similar assessment methods are being used for different purposes in surgical training, the psychometric properties of these assessment methods have not been examined separately for each purpose. Because of the significance of these assessments for trainees and patients, their reliability and validity should be examined thoroughly in every context where the assessment method is being used.

  6. 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 ...

  7. Role of Skill Laboratory Training in Medical Education - Students Perspective

    International Nuclear Information System (INIS)

    Hashim, R.; Qamar, K.; Rehman, S.; Khan, M. A.

    2016-01-01

    Objective: To evaluate the perceptions of medical students regarding their training utilizing facilities provided in the skill laboratory of a public sector medical college. Study Design: Cross-sectional study. Place and Duration of Study: Army Medical College, Rawalpindi, from October to December 2014. Methodology: Students of final year MBBS who had underwent skill laboratory training were recruited through convenience purposive sampling. Students not exposed to skill laboratory training were excluded. Data collection tool was a questionnaire having 23 questions with responses on Likert Scale as strongly disagree, disagree, agree and strongly agree coded as 1, 2, 3 and 4, respectively. Data was analysed on SPSS version 22. Results: There were 78 (57 percent) male and 59 (43 percent) female students out of 137, with mean age of 22.59 ± 0.74 years. The response rate was 68.5 percent. Cronbach's Alpha test was 0.84 showing high reliability. The mean of sum of all the 23 items was 63.85 ± 8.71, whereas item means was 2.78 ± 0.38, reflecting a high inclination of students towards skill laboratory training. Frequency of students responding in favour of skill laboratory training was significantly high (p < 0.05). Conclusion: Medical students perceived skill laboratory training as a favoured learning strategy as compared to practising on real patients for acquisition of various aspects of clinical skills, knowledge and attitude. (author)

  8. Clerkship maturity: does the idea of training clinical skills work?

    Science.gov (United States)

    Stosch, Christoph; Joachim, Alexander; Ascher, Johannes

    2011-01-01

    With the reformed curriculum "4C", the Medical Faculty of the University of Cologne has started to systematically plan practical skills training, for which Clerkship Maturity is the first step. The key guidelines along which the curriculum was development were developed by experts. This approach has now been validated. Both students and teachers were asked to fill in a questionnaire regarding preclinical practical skills training to confirm the concept of Clerkship Maturity. The Cologne training program Clerkship Maturity can be validated empirically overall through the activities of the students awaiting the clerkship framework and through the evaluation by the medical staff providing the training. The subjective ratings of the advantages of the training by the students leave room for improvement. Apart from minor improvements to the program, the most likely solution providing sustainable results will involve an over-regional strategy for establishing skills training planned as part of the curriculum.

  9. Immersive virtual reality used as a platform for perioperative training for surgical residents.

    Science.gov (United States)

    Witzke, D B; Hoskins, J D; Mastrangelo, M J; Witzke, W O; Chu, U B; Pande, S; Park, A E

    2001-01-01

    Perioperative preparations such as operating room setup, patient and equipment positioning, and operating port placement are essential to operative success in minimally invasive surgery. We developed an immersive virtual reality-based training system (REMIS) to provide residents (and other health professionals) with training and evaluation in these perioperative skills. Our program uses the qualities of immersive VR that are available today for inclusion in an ongoing training curriculum for surgical residents. The current application consists of a primary platform for patient positioning for a laparoscopic cholecystectomy. Having completed this module we can create many different simulated problems for other procedures. As a part of the simulation, we have devised a computer-driven real-time data collection system to help us in evaluating trainees and providing feedback during the simulation. The REMIS program trains and evaluates surgical residents and obviates the need to use expensive operating room and surgeon time. It also allows residents to train based on their schedule and does not put patients at increased risk. The method is standardized, allows for repetition if needed, evaluates individual performance, provides the possible complications of incorrect choices, provides training in 3-D environment, and has the capability of being used for various scenarios and professions.

  10. Training basic laparoscopic skills using a custom-made video game

    OpenAIRE

    Goris, Jetse; Jalink, Maarten B.; ten Cate Hoedemaker, Henk O.

    2014-01-01

    Video games are accepted and used for a wide variety of applications. In the medical world, research on the positive effects of playing games on basic laparoscopic skills is rapidly increasing. Although these benefits have been proven several times, no institution actually uses video games for surgical training. This Short Communication describes some of the theoretical backgrounds, development and underlying educational foundations of a specifically designed video game and custom-made hardwa...

  11. Surgical education and training in an outer metropolitan hospital: a qualitative study of surgical trainers and trainees.

    Science.gov (United States)

    Nestel, Debra; Harlim, Jennifer; Bryant, Melanie; Rampersad, Rajay; Hunter-Smith, David; Spychal, Bob

    2017-08-01

    The landscape of surgical training is changing. The anticipated increase in the numbers of surgical trainees and the shift to competency-based surgical training places pressures on an already stretched health service. With these pressures in mind, we explored trainers' and trainees' experiences of surgical training in a less traditional rotation, an outer metropolitan hospital. We considered practice-based learning theories to make meaning of surgical training in this setting, in particular Actor-network theory. We adopted a qualitative approach and purposively sampled surgical trainers and trainees to participate in individual interviews and focus groups respectively. Transcripts were made and thematically analysed. Institutional human research ethics approval was obtained. Four surgical trainers and fourteen trainees participated. Almost without exception, participants' report training needs to be well met. Emergent inter-related themes were: learning as social activity; learning and programmatic factors; learning and physical infrastructure; and, learning and organizational structure. This outer metropolitan hospital is suited to the provision of surgical training with the current rotational system for trainees. The setting offers experiences that enable consolidation of learning providing a rich and varied overall surgical training program. Although relational elements of learning were paramount they occurred within a complex environment. Actor-network theory was used to give meaning to emergent themes acknowledging that actors (both people and objects) and their interactions combine to influence training quality, shifting the focus of responsibility for learning away from individuals to the complex interactions in which they work and learn.

  12. Digital Skill Training Research: Preliminary Guidelines for Distributed Learning

    National Research Council Canada - National Science Library

    Childs, Jerry

    2001-01-01

    This task was aimed at the development of guidelines for distributed learning (DL). A matrix was generated to evaluate the effectiveness of various DL media for training representative knowledge/skill types...

  13. Professional skills training proposal for professors of health programs

    Directory of Open Access Journals (Sweden)

    Mauricio Alberto Ángel-Macías

    2017-10-01

    Conclusions: This study shows the urgent need for creating training spaces in pedagogy, didactics and evaluation. In consequence, a model that includes cognitive, methodological, social and personal skills is proposed.

  14. Increasing the efficiency of laparoscopic surgical training : assessing the effectiveness of training interventions

    NARCIS (Netherlands)

    Spruit, E.N.

    2018-01-01

    In the current project, our main focus was to test the effectiveness of different training interventions and their impact on skill acquisition and long-term retention of laparoscopic motor skills. Based on the research in this dissertation and the existing literature, I recommend instructors to

  15. Hyper-Realistic, Team-Centered Fleet Surgical Team Training Provides Sustained Improvements in Performance.

    Science.gov (United States)

    Hoang, Tuan N; Kang, Jeff; Siriratsivawong, Kris; LaPorta, Anthony; Heck, Amber; Ferraro, Jessica; Robinson, Douglas; Walsh, Jonathan

    2016-01-01

    The high-stress, fast-paced environment of combat casualty care relies on effective teamwork and communication which translates into quality patient care. A training course was developed for U.S. Navy Fleet Surgical Teams to address these aspects of patient care by emphasizing efficiency and appropriate patient care. An effective training course provides knowledge and skills to pass the course evaluation and sustain the knowledge and skills acquired over time. The course included classroom didactic hours, and hands-on simulation sessions. A pretest was administered before the course, a posttest upon completion, and a sustainment test 5 months following course completion. The evaluation process measured changes in patient time to disposition and critical errors made during patient care. Naval Base San Diego, with resuscitation and surgical simulations carried out within the shipboard medical spaces. United States Navy medical personnel including physicians of various specialties, corpsmen, nurses, and nurse anesthetists deploying aboard ships. Time to disposition improved significantly, 11 ± 3 minutes, from pretest to posttest, and critical errors improved by 4 ± 1 errors per encounter. From posttest to sustainment test, time to disposition increased by 3 ± 1, and critical errors decreased by 1 ± 1. This course showed value in improving teamwork and communication skills of participants, immediately upon completion of the course, and after 5 months had passed. Therefore, with ongoing sustainment activities within 6 months, this course can substantially improve trauma care provided by shipboard deployed Navy medical personnel to wounded service members. Published by Elsevier Inc.

  16. Evaluating veterinary practitioner perceptions of communication skills and training

    OpenAIRE

    McDermott, M.P.; Cobb, M.A.; Tischler, Victoria; Robbé, I.J.; Dean, R.S.

    2017-01-01

    A survey was conducted among veterinary practitioners in the UK and the USA in 2012/2013. Thematic analysis was used to identify underlying reasons behind answers to questions about the importance of communication skills and the desire to participate in postgraduate communication skills training. Lack of training among more experienced veterinary surgeons, incomplete preparation of younger practitioners and differences in ability to communicate all contribute to gaps in communication competen...

  17. Subspecialist training in surgical gynecological oncology in the nordic countries

    DEFF Research Database (Denmark)

    Antonsen, Sofie L; Avall-Lundqvist, Elisabeth; Salvesen, Helga B

    2011-01-01

    To survey the centers that can provide subspecialty surgical training and education in gynecological oncology in the Nordic countries we developed an online questionnaire in cooperation with the Nordic Society of Gynecological Oncology. The link to the survey was mailed to 22 Scandinavian...... (74%) centers were interested in being listed for exchange of fellows. Our data show a large Nordic potential and interest in improving the gynecologic oncology standards and can be used to enhance the awareness of gynecological oncology training in Scandinavia and to facilitate the exchange...

  18. 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.

  19. A management framework for training providers to improve skills ...

    African Journals Online (AJOL)

    Erna Kinsey

    The competence levels of employees and organisations must be audited to determine the organisation's skills bank and stra- tegic plans for the future. The cost of training is also a significant management-planning question. Current workplace skills development legislation and strategies are aimed at curbing ineffective ...

  20. Mental Skills Training Experience of NCAA Division II Softball Catchers

    Science.gov (United States)

    Norman, Shannon

    2012-01-01

    Athletes competing at all levels of sport are constantly working on ways to enhance their physical performance. Sport psychology research insists there are higher performance results among athletes who incorporate mental skills training into their practice and competition settings. In order to use the mental skills strategies effectively, athletes…

  1. Training basic laparoscopic skills using a custom-made video game.

    Science.gov (United States)

    Goris, Jetse; Jalink, Maarten B; Ten Cate Hoedemaker, Henk O

    2014-09-01

    Video games are accepted and used for a wide variety of applications. In the medical world, research on the positive effects of playing games on basic laparoscopic skills is rapidly increasing. Although these benefits have been proven several times, no institution actually uses video games for surgical training. This Short Communication describes some of the theoretical backgrounds, development and underlying educational foundations of a specifically designed video game and custom-made hardware that takes advantage of the positive effects of games on basic laparoscopic skills.

  2. Unexpected pathological findings in skills training and assessing skills

    NARCIS (Netherlands)

    Boendermaker, PM; Pols, J; Scherpbier, AJJA

    This article draws attention to unexpected pathological findings encountered by students and teachers when examining one another and/or simulated patients in skips training and assessment sessions. Although no literature on the subject was found it appears to be not uncommon far students and

  3. Music training for the development of reading skills.

    Science.gov (United States)

    Tierney, Adam; Kraus, Nina

    2013-01-01

    The beneficial effects of musical training are not limited to enhancement of musical skills, but extend to language skills. Here, we review evidence that musical training can enhance reading ability. First, we discuss five subskills underlying reading acquisition-phonological awareness, speech-in-noise perception, rhythm perception, auditory working memory, and the ability to learn sound patterns-and show that each is linked to music experience. We link these five subskills through a unifying biological framework, positing that they share a reliance on auditory neural synchrony. After laying this theoretical groundwork for why musical training might be expected to enhance reading skills, we review the results of longitudinal studies providing evidence for a role for musical training in enhancing language abilities. Taken as a whole, these findings suggest that musical training can provide an effective developmental educational strategy for all children, including those with language learning impairments. © 2013 Elsevier B.V. All rights reserved.

  4. Effect of Continuous Motion Parameter Feedback on Laparoscopic Simulation Training: A Prospective Randomized Controlled Trial on Skill Acquisition and Retention.

    Science.gov (United States)

    Buescher, Julian Frederik; Mehdorn, Anne-Sophie; Neumann, Philipp-Alexander; Becker, Felix; Eichelmann, Ann-Kathrin; Pankratius, Ulrich; Bahde, Ralf; Foell, Daniel; Senninger, Norbert; Rijcken, Emile

    To investigate the effect of motion parameter feedback on laparoscopic basic skill acquisition and retention during a standardized box training curriculum. A Lap-X Hybrid laparoscopic simulator was designed to provide individual and continuous motion parameter feedback in a dry box trainer setting. In a prospective controlled trial, surgical novices were randomized into 2 groups (regular box group, n = 18, and Hybrid group, n = 18) to undergo an identical 5-day training program. In each group, 7 standardized tasks on laparoscopic basic skills were completed twice a day on 4 consecutive days in fixed pairs. Additionally, each participant performed a simulated standard laparoscopic cholecystectomy before (day 1) and after training (day 5) on a LAP Mentor II virtual reality (VR) trainer, allowing an independent control of skill progress in both groups. A follow-up assessment of skill retention was performed after 6 weeks with repetition of both the box tasks and VR cholecystectomy. Muenster University Hospital Training Center, Muenster, Germany. Medical students without previous surgical experience. Laparoscopic skills in both groups improved significantly during the training period, measured by the overall task performance time. The 6 week follow-up showed comparable skill retention in both groups. Evaluation of the VR cholecystectomies demonstrated significant decrease of operation time (p Simulation training on both trainers enables reliable acquisition of laparoscopic basic skills. Furthermore, individual and continuous motion feedback improves laparoscopic skill enhancement significantly in several aspects. Thus, training systems with feedback of motion parameters should be considered to achieve long-term improvement of motion economy among surgical trainees. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  5. Surgical training, duty-hour restrictions, and implications for meeting the Accreditation Council for Graduate Medical Education core competencies: views of surgical interns compared with program directors.

    Science.gov (United States)

    Antiel, Ryan M; Van Arendonk, Kyle J; Reed, Darcy A; Terhune, Kyla P; Tarpley, John L; Porterfield, John R; Hall, Daniel E; Joyce, David L; Wightman, Sean C; Horvath, Karen D; Heller, Stephanie F; Farley, David R

    2012-06-01

    To describe the perspectives of surgical interns regarding the implications of the new Accreditation Council for Graduate Medical Education (ACGME) duty-hour regulations for their training. We compared responses of interns and surgery program directors on a survey about the proposed ACGME mandates. Eleven general surgery residency programs. Two hundred fifteen interns who were administered the survey during the summer of 2011 and a previously surveyed national sample of 134 surgery program directors. Perceptions of the implications of the new duty-hour restrictions on various aspects of surgical training, including the 6 ACGME core competencies of graduate medical education, measured using 3-point scales (increase, no change, or decrease). Of 215 eligible surgical interns, 179 (83.3%) completed the survey. Most interns believed that the new duty-hour regulations will decrease continuity with patients (80.3%), time spent operating (67.4%), and coordination of patient care (57.6%), while approximately half believed that the changes will decrease their acquisition of medical knowledge (48.0%), development of surgical skills (52.8%), and overall educational experience (51.1%). Most believed that the changes will improve or will not alter other aspects of training, and 61.5% believed that the new standards will decrease resident fatigue. Surgical interns were significantly less pessimistic than surgery program directors regarding the implications of the new duty-hour restrictions on all aspects of surgical training (P training under the new paradigm of duty-hour restrictions have significant concerns about the effect of these regulations on the quality of their training.

  6. Training Literacy Skills through Sign Language

    Science.gov (United States)

    Rudner, Mary; Andin, Josefine; Rönnberg, Jerker; Heimann, Mikael; Hermansson, Anders; Nelson, Keith; Tjus, Tomas

    2015-01-01

    The literacy skills of deaf children generally lag behind those of their hearing peers. The mechanisms of reading in deaf individuals are only just beginning to be unraveled but it seems that native language skills play an important role. In this study 12 deaf pupils (six in grades 1-2 and six in grades 4-6) at a Swedish state primary school for…

  7. Communication Skills Training in the Medical Curriculum

    OpenAIRE

    Branet Partric; Yasar Albushra Ahmed

    2013-01-01

    Communication is an essential skill in the armory of any worker in the health field. It is an integral part of the skills required, not only in medical doctors, but in all health workers. Communication is more than history taking; it includes all methods of interaction with patients, patient's relatives, members of the health care team, and the public. Many studies stressed that the main complaints of patients are related to communication problems and not to clinical competency. This has cont...

  8. Communication Skills Training in the Medical Curriculum

    Directory of Open Access Journals (Sweden)

    Branet Partric

    2013-01-01

    Full Text Available Communication is an essential skill in the armory of any worker in the health field. It is an integral part of the skills required, not only in medical doctors, but in all health workers. Communication is more than history taking; it includes all methods of interaction with patients, patient's relatives, members of the health care team, and the public. Many studies stressed that the main complaints of patients are related to communication problems and not to clinical competency. This has contributed to an increase in the number of law suits, non-adherence to medical regimens, and the tendency of patients to keep changing physicians and hospitals. Also, it has been shown that health outcome is positively affected by proper communication. This includes patient's satisfaction and cooperation, decrease in treatment duration, decrease in painkillers requirements, and decrease in hospital stay. Also, it has been shown that communication skills can be taught and important changes in physician's behavior and in their communication skills have been demonstrated after courses of communication skills. Thus, many medical colleges in the world are including communication skills courses in their undergraduate and graduate curricula

  9. 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.

  10. Communication Skills Training in Pediatric Oncology: Moving Beyond Role Modeling

    Science.gov (United States)

    Feraco, Angela M.; Brand, Sarah R.; Mack, Jennifer W.; Kesselheim, Jennifer C.; Block, Susan D.; Wolfe, Joanne

    2018-01-01

    Communication is central to pediatric oncology care. Pediatric oncologists disclose life-threatening diagnoses, explain complicated treatment options, and endeavor to give honest prognoses, to maintain hope, to describe treatment complications, and to support families in difficult circumstances ranging from loss of function and fertility to treatment-related or disease-related death. However, parents, patients, and providers report substantial communication deficits. Poor communication outcomes may stem, in part, from insufficient communication skills training, overreliance on role modeling, and failure to utilize best practices. This review summarizes evidence for existing methods to enhance communication skills and calls for revitalizing communication skills training within pediatric oncology. PMID:26822066

  11. Communication Skills Training in Pediatric Oncology: Moving Beyond Role Modeling.

    Science.gov (United States)

    Feraco, Angela M; Brand, Sarah R; Mack, Jennifer W; Kesselheim, Jennifer C; Block, Susan D; Wolfe, Joanne

    2016-06-01

    Communication is central to pediatric oncology care. Pediatric oncologists disclose life-threatening diagnoses, explain complicated treatment options, and endeavor to give honest prognoses, to maintain hope, to describe treatment complications, and to support families in difficult circumstances ranging from loss of function and fertility to treatment-related or disease-related death. However, parents, patients, and providers report substantial communication deficits. Poor communication outcomes may stem, in part, from insufficient communication skills training, overreliance on role modeling, and failure to utilize best practices. This review summarizes evidence for existing methods to enhance communication skills and calls for revitalizing communication skills training within pediatric oncology. © 2016 Wiley Periodicals, Inc.

  12. [Feedback in relation to training of practical clinical skills

    DEFF Research Database (Denmark)

    Hansen, C.S.; Ringsted, Charlotte Vibeke

    2008-01-01

    Feedback has been identified as an essential component of motor learning. However, feedback principles derived from motor learning theories cannot uncritically be applied to clinical skills training because this knowledge is based primarily on the study of very simple motor skills. Research...... into feedback in relation to clinical skills training is currently limited. Theories on motor learning can serve as the basis for designing research in this domain, especially the importance of including retention tests when measuring permanent learning outcomes Udgivelsesdato: 2008/10/27...

  13. Surgical simulators in urological training--views of UK Training Programme Directors.

    Science.gov (United States)

    Forster, James A; Browning, Anthony J; Paul, Alan B; Biyani, C Shekhar

    2012-09-01

    What's known on the subject? and What does the study add? The role of surgical simulators is currently being debated in urological and other surgical specialties. Simulators are not presently implemented in the UK urology training curriculum. The availability of simulators and the opinions of Training Programme Directors' (TPD) on their role have not been described. In the present questionnaire-based survey, the trainees of most, but not all, UK TPDs had access to laparoscopic simulators, and that all responding TPDs thought that simulators improved laparoscopic training. We hope that the present study will be a positive step towards making an agreement to formally introduce simulators into the UK urology training curriculum. To discuss the current situation on the use of simulators in surgical training. To determine the views of UK Urology Training Programme Directors (TPDs) on the availability and use of simulators in Urology at present, and to discuss the role that simulators may have in future training. An online-questionnaire survey was distributed to all UK Urology TPDs. In all, 16 of 21 TPDs responded. All 16 thought that laparoscopic simulators improved the quality of laparoscopic training. The trainees of 13 TPDs had access to a laparoscopic simulator (either in their own hospital or another hospital in the deanery). Most TPDs thought that trainees should use simulators in their free time, in quiet time during work hours, or in teaching sessions (rather than incorporated into the weekly timetable). We feel that the current apprentice-style method of training in urological surgery is out-dated. We think that all TPDs and trainees should have access to a simulator, and that a formal competency based simulation training programme should be incorporated into the urology training curriculum, with trainees reaching a minimum proficiency on a simulator before undertaking surgical procedures. © 2012 THE AUTHORS. BJU INTERNATIONAL © 2012 BJU INTERNATIONAL.

  14. Fundamentals of neurosurgery: virtual reality tasks for training and evaluation of technical skills.

    Science.gov (United States)

    Choudhury, Nusrat; Gélinas-Phaneuf, Nicholas; Delorme, Sébastien; Del Maestro, Rolando

    2013-11-01

    Technical skills training in neurosurgery is mostly done in the operating room. New educational paradigms are encouraging the development of novel training methods for surgical skills. Simulation could answer some of these needs. This article presents the development of a conceptual training framework for use on a virtual reality neurosurgical simulator. Appropriate tasks were identified by reviewing neurosurgical oncology curricula requirements and performing cognitive task analyses of basic techniques and representative surgeries. The tasks were then elaborated into training modules by including learning objectives, instructions, levels of difficulty, and performance metrics. Surveys and interviews were iteratively conducted with subject matter experts to delimitate, review, discuss, and approve each of the development stages. Five tasks were selected as representative of basic and advanced neurosurgical skill. These tasks were: 1) ventriculostomy, 2) endoscopic nasal navigation, 3) tumor debulking, 4) hemostasis, and 5) microdissection. The complete training modules were structured into easy, intermediate, and advanced settings. Performance metrics were also integrated to provide feedback on outcome, efficiency, and errors. The subject matter experts deemed the proposed modules as pertinent and useful for neurosurgical skills training. The conceptual framework presented here, the Fundamentals of Neurosurgery, represents a first attempt to develop standardized training modules for technical skills acquisition in neurosurgical oncology. The National Research Council Canada is currently developing NeuroTouch, a virtual reality simulator for cranial microneurosurgery. The simulator presently includes the five Fundamentals of Neurosurgery modules at varying stages of completion. A first pilot study has shown that neurosurgical residents obtained higher performance scores on the simulator than medical students. Further work will validate its components and use in a

  15. Understanding the Effect of Skills Training on Women's Economic ...

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

    This project will evaluate the impact of skills training on women's livelihoods in rural ... returns on training and reduce barriers to women's financial well-being. ... The PSDF is a joint UK Department for International Development-Pakistan and ... Call for new OWSD Fellowships for Early Career Women Scientists now open.

  16. Training of Perceptual Motor Skills in Multimodal Virtual Environments

    Directory of Open Access Journals (Sweden)

    Gopher Daniel

    2011-12-01

    Full Text Available Multimodal, immersive, virtual reality (VR techniques open new perspectives for perceptualmotor skill trainers. They also introduce new risks and dangers. This paper describes the benefits and pitfalls of multimodal training and the cognitive building blocks of a multimodal, VR training simulators.

  17. Hospitality Occupational Skills Training Cooperative. Project HOST Final Report.

    Science.gov (United States)

    Northwest Educational Cooperative, Des Plaines, IL.

    Project HOST (Hospitality Occupational Skills Training) provided vocational training and employment opportunities in the hotel industry to disadvantaged adult minority populations in Chicago. It demonstrated a model for successful cooperation between the business sector and a public vocational education agency and developed and piloted a…

  18. Gaze-contingent training enhances perceptual skill acquisition

    NARCIS (Netherlands)

    Mann, D.L.; Ryu, D.; Abernethy, B.A.; Poolton, J.M.

    2016-01-01

    The purpose of this study was to determine whether decision-making skill in perceptual-cognitive tasks could be enhanced using a training technique that impaired selective areas of the visual field. Recreational basketball players performed perceptual training over 3 days while viewing with a

  19. Development and evaluation of a simulator-based laparoscopic training program for surgical novices.

    Science.gov (United States)

    Nugent, Emmeline; Shirilla, Nicole; Hafeez, Adnan; O'Riordain, Diarmuid S; Traynor, Oscar; Harrison, Anthony M; Neary, Paul

    2013-01-01

    The use of simulation to train novice surgeons in laparoscopic skills is becoming increasingly popular. To maximize benefit from simulation, training needs to be delivered and assessed in a structured manner. This study aimed to define performance goals, demonstrate construct validity of the training program, and evaluate whether novice surgeons could reach the preset performance goals. Nine expert laparoscopic surgeons established performance goals for three basic modules of an augmented-reality laparoscopic simulator. The three laparoscopic modules were used by 40 novice surgeons and 40 surgical trainees (postgraduate years [PGYs] 1-4). The performance outcomes were analyzed across the different groups (novice, PGYs 1 and 2, PGYs 3 and 4, expert) to determine construct validity. Then 26 recruited novices trained on the three modules with the aim of reaching the performance goals. The results demonstrated a significant difference in performance between all levels of experience for time (p < 0.001), motion analysis (p < 0.001), and error score (p < 0.001), thus demonstrating construct validity. All 26 novice surgeons significantly improved in performance with repetition for the metrics of time (p < 0.001) and motion analysis (p < 0.001). For two of the modules, the proficiency goals were reached in fewer than 10 trials by 80% of the study participants. Basic skills in laparoscopic surgery can be learned and improved using proficiency-based simulation training. It is possible for novice surgeons to achieve predefined performance goals in a reasonable time frame.

  20. Trained, Generalized, and Collateral Behavior Changes of Preschool Children Receiving Gross-Motor Skills Training.

    Science.gov (United States)

    Kirby, Kimberly C.; Holborn, Stephen W.

    1986-01-01

    Three preschool children participated in a behavioral training program to improve their gross-motor skills. Results indicated that the program improved the 10 targeted gross-motor skills and that improvements sometimes generalized to other settings. The program did not produce changes in fine-motor skills or social behaviors. Implications are…

  1. Using Behavioral Skills Training and Video Rehearsal to Teach Blackjack Skills

    Science.gov (United States)

    Speelman, Ryan C.; Whiting, Seth W.; Dixon, Mark R.

    2015-01-01

    A behavioral skills training procedure that consisted of video instructions, video rehearsal, and video testing was used to teach 4 recreational gamblers a specific skill in playing blackjack (sometimes called "card counting"). A multiple baseline design was used to evaluate intervention effects on card-counting accuracy and chips won or…

  2. Social Skills Training for Young Adolescents.

    Science.gov (United States)

    Wise, Kathryn L.; And Others

    1991-01-01

    Six-session systematic assertiveness training program based on social cognitive theory and focusing on peer interactions and social responsibility was presented to 22 sixth graders. Compared to control group, students who received training performed significantly better on test of cognitive acquisition of the information at posttest and six-month…

  3. Developing soft skill training for salespersons to increase total sales

    Science.gov (United States)

    Mardatillah, A.; Budiman, I.; Tarigan, U. P. P.; Sembiring, A. C.; Hendi

    2018-04-01

    This research was conducted in the multilevel marketing industry. Unprofessional salespersons behavior and responsibility can ruin the image of the multilevel marketing industry and distrust to the multilevel marketing industry. This leads to decreased company revenue due to lack of public interest in multilevel marketing products. Seeing these conditions, researcher develop training programs to improve the competence of salespersons in making sales. It was done by looking at factors that affect the level of salespersons sales. The research analyzes several factors that influence the salesperson’s sales level: presentation skills, questioning ability, adaptability, technical knowledge, self-control, interaction involvement, sales environment, and intrapersonal skills. Through the analysis of these factors with One Sample T-Test and Multiple Linear Regression methods, researchers design a training program for salespersons to increase their sales. The developed training for salespersons is basic training and special training and before training was given, salespersons need to be assessed for the effectivity and efficiency reasons.

  4. [Integrated skills laboratory concept for undergraduate training in internal medicine].

    Science.gov (United States)

    Nikendei, C; Schilling, T; Nawroth, P; Hensel, M; Ho, A D; Schwenger, V; Zeier, M; Herzog, W; Schellberg, D; Katus, H A; Dengler, T; Stremmel, W; Müller, M; Jünger, J

    2005-05-06

    An amendment to the German medical curriculum in April 2002 will place basic practical skills at the centre of medical training. We report here on the implementation and evaluation of an obligatory, tutor-guided, and integrated skills laboratory concept in the field of internal medicine. To test the effectiveness of a skills laboratory training on OSCE performance a pilot study was carried out. The experimental group, of 77 students, participated in seven sessions of communication training, skills laboratory training, and bedside teaching, each lasting one and a half hours. The control group of 66 students had as many sessions but was only offered bedside-teaching. The evaluation of acceptance of skills' training as well as the related increase in individual competence is on-going (summer term 2004: n = 176 students). The integrated skills laboratory concept was rated at 3.5 (SD = 1.2) on a 5-point scale and was acknowledged as practice-oriented (M = 4.2; SD = 1.0) and relevant for doctors' everyday lives (M = 3.6; SD = 1.1). Increased levels of competence according to individual self-evaluations proved to be highly significant (p<.001), and results of the pilot study showed that the experimental group had a significantly better OSCE performance than the control group (p<.001). This pilot study shows that curriculum changes promoting basic clinical skills are effective and lead to an improved practical education of tomorrow's physicians. The integrated skills laboratory concept is well accepted and leads to a relevant increase in competence in the practice of internal medical. The presented skills laboratory concept in internal medicine is proving to be a viable and efficient learning tool.

  5. Skill gap analysis and training needs in Indian aerospace industry

    Directory of Open Access Journals (Sweden)

    Premkumar Balaraman

    2016-12-01

    Full Text Available Purpose: The main objective of the paper is on assessing the global aerospace industry as well as Indian scenario, and attempts to assess the skill gaps and training needs of Indian aerospace industry.  Design/methodology/approach: The study is qualitative in nature, and employs wide array of qualitative tools which includes desktop study, focus group interviews and secondary sources of information. Around 10 focus groups were used in the study, with each focus group having a minimum of 6 members of experts in the aerospace and allied industries. The study evolved into a 2 staged one, with the first study elucidating the growing importance and potential of aerospace industry, justifying the significance to take forward the second part of the study. And the second study specifically focuses on skill gaps and training needs. Findings and Originality/value: The Study yields varied results on existing generic expectations of aerospace industry, specific needs of aerospace industry, identification of aerospace job categories unique to aerospace industry, key issues of training in Indian scenario and recommendations. The paper in summary reflects the current scenario of aerospace industry potentials for India and its likely impact on skills gap and training needs. Practical implications: Skills gap is a significant gap between an organization’s current capabilities and the skills it needs to achieve its goals. As a number of Global forecasts project, India as an emerging aviation market, the skill gaps in this sector is predicted to be huge and necessitates the study on assessing the skill gaps and its allied training needs. Originality/value: The Study is highly original and first one of its kind in reflecting the current situation of the skills gap and training needs in Indian Aerospace industry. The focus group interviews were conducted with the experts at various levels in the industyr without any bias yielding valid and realtime data for the

  6. Recommended observational skills training for IAEA safeguards inspections. Final report: Recommended observational skills training for IAEA safeguards inspections

    Energy Technology Data Exchange (ETDEWEB)

    Toquam, J.L.; Morris, F.A.

    1994-09-01

    This is the second of two reports prepared to assist the International Atomic Energy Agency (IAEA or Agency) in enhancing the effectiveness of its international safeguards inspections through inspector training in {open_quotes}Observational Skills{close_quotes}. The first (Phase 1) report was essentially exploratory. It defined Observational Skills broadly to include all appropriate cognitive, communications, and interpersonal techniques that have the potential to help IAEA safeguards inspectors function more effectively. It identified 10 specific Observational Skills components, analyzed their relevance to IAEA safeguards inspections, and reviewed a variety of inspection programs in the public and private sectors that provide training in one or more of these components. The report concluded that while it should be possible to draw upon these other programs in developing Observational Skills training for IAEA inspectors, the approaches utilized in these programs will likely require significant adaption to support the specific job requirements, policies, and practices that define the IAEA inspector`s job. The overall objective of this second (Phase 2) report is to provide a basis for the actual design and delivery of Observational Skills training to IAEA inspectors. The more specific purposes of this report are to convey a fuller understanding of the potential application of Observational Skills to the inspector`s job, describe inspector perspectives on the relevance and importance of particular Observational Skills, identify the specific Observational Skill components that are most important and relevant to enhancing safeguards inspections, and make recommendations as to Observational Skills training for the IAEA`s consideration in further developing its Safeguards training program.

  7. Appropriate working hours for surgical training according to Australasian trainees.

    Science.gov (United States)

    O'Grady, Gregory; Harper, Simon; Loveday, Benjamin; Adams, Brandon; Civil, Ian D; Peters, Matthew

    2012-04-01

    The demands of surgical training, learning and service delivery compete with the need to minimize fatigue and maintain an acceptable lifestyle. The optimal balance of working hours is uncertain. This study aimed to define the appropriate hours to meet these requirements according to trainees. All Australian and New Zealand surgical trainees were surveyed. Roster structures, weekly working hours and weekly 'sleep loss hours' (work practices were then correlated with sufficiency of training time, time for study, fatigue and its impacts, and work-life balance preferences. Multivariate and univariate analyses were performed. The response rate was 55.3% with responders representative of the total trainee body. Trainees who worked median 60 h/week (interquartile range: 55-65) considered their work hours to be appropriate for 'technical' and 'non-technical' training needs compared with 55 h/week (interquartile range: 50-60) regarded as appropriate for study/research needs. Working ≥65 h/week, or accruing ≥5.5 weekly 'sleep loss hours', was associated with increased fatigue, reduced ability to study, more frequent dozing while driving and impaired concentration at work. Trainees who considered they had an appropriate work-life balance worked median 55 h/week. Approximately, 60 h/week proved an appropriate balance of working hours for surgical training, although study and lifestyle demands are better met at around 55 h/week. Sleep loss is an important determinant of fatigue and its impacts, and work hours should not be considered in isolation. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  8. Surgical skills deficiencies and needs of rural general practitioners ...

    African Journals Online (AJOL)

    This open-access article is distributed under. Creative ... procedures performed in rural hospitals in Africa; and Framework for CPD ..... quality surgical care in rural areas is a challenge faced by the present .... Mullan F. The metrics of the physician brain drain. N Engl J Med ... Dare AJ, NgKamstra JS, Patra J, et al. Deaths ...

  9. Does Music Training Enhance Literacy Skills? A Meta-Analysis

    Science.gov (United States)

    Gordon, Reyna L.; Fehd, Hilda M.; McCandliss, Bruce D.

    2015-01-01

    Children's engagement in music practice is associated with enhancements in literacy-related language skills, as demonstrated by multiple reports of correlation across these two domains. Training studies have tested whether engaging in music training directly transfers benefit to children's literacy skill development. Results of such studies, however, are mixed. Interpretation of these mixed results is made more complex by the fact that a wide range of literacy-related outcome measures are used across these studies. Here, we address these challenges via a meta-analytic approach. A comprehensive literature review of peer-reviewed music training studies was built around key criteria needed to test the direct transfer hypothesis, including: (a) inclusion of music training vs. control groups; (b) inclusion of pre- vs. post-comparison measures, and (c) indication that reading instruction was held constant across groups. Thirteen studies were identified (n = 901). Two classes of outcome measures emerged with sufficient overlap to support meta-analysis: phonological awareness and reading fluency. Hours of training, age, and type of control intervention were examined as potential moderators. Results supported the hypothesis that music training leads to gains in phonological awareness skills. The effect isolated by contrasting gains in music training vs. gains in control was small relative to the large variance in these skills (d = 0.2). Interestingly, analyses revealed that transfer effects for rhyming skills tended to grow stronger with increased hours of training. In contrast, no significant aggregate transfer effect emerged for reading fluency measures, despite some studies reporting large training effects. The potential influence of other study design factors were considered, including intervention design, IQ, and SES. Results are discussed in the context of emerging findings that music training may enhance literacy development via changes in brain mechanisms that

  10. 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.

  11. Nontechnical skills training for the operating room: A prospective study using simulation and didactic workshop.

    Science.gov (United States)

    Pena, Guilherme; Altree, Meryl; Field, John; Sainsbury, David; Babidge, Wendy; Hewett, Peter; Maddern, Guy

    2015-07-01

    The best surgeons demonstrate skills beyond those required for the performance of technically competent surgery. These skills are described under the term nontechnical skills. Failure in these domains has been associated with adverse events inside the operating room. These nontechnical skills are not learned commonly in a structured manner during surgery training. The main purpose of this study was to explore the effects of participation in simulation-based training, either as a sole strategy or as part of a combined approach on surgeons and surgical trainees nontechnical skills performance in simulation environment. The study consisted of a single-blinded, prospective comparative trial. Forty participants were enrolled, all participating in 2 simulation sessions challenging nontechnical skills comprising 3 surgical scenarios. Seventeen participants attended a 1-day, nontechnical skills workshop between simulation sessions. Scenarios were video-recorded for assessment and debriefing purposes. Assessment was made by 2 observers using the Non-Technical Skills for Surgeons (NOTSS) scoring system. There was a significant improvement in nontechnical skills performance of both groups from the first to the second simulation session, for 2 of the 3 scenarios. No difference in performance between the simulation and the simulation plus workshop groups was noted. This study provides evidence that formal training in nontechnical skills is feasible and can impact positively participants' nontechnical performance in a simulated environment. The addition of a 1-day didactic workshop does not seem to provide additional benefit over simulation-based training as a sole strategy for nontechnical skills training. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. 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

  13. Communication Skills Training Exploiting Multimodal Emotion Recognition

    Science.gov (United States)

    Bahreini, Kiavash; Nadolski, Rob; Westera, Wim

    2017-01-01

    The teaching of communication skills is a labour-intensive task because of the detailed feedback that should be given to learners during their prolonged practice. This study investigates to what extent our FILTWAM facial and vocal emotion recognition software can be used for improving a serious game (the Communication Advisor) that delivers a…

  14. Staff's perceptions of voluntary assertiveness skills training.

    Science.gov (United States)

    McVanel, Sarah; Morris, Beth

    2010-01-01

    Clinicians' ability to be assertive when unsure or concerned about procedures, treatment modalities, or patients' symptoms is key in reducing risk and preventing sentinel events. In this article, the authors provide a framework for generic, voluntary assertiveness communication skills workshops that any educator can implement.

  15. Taking control: Is job crafting related to the intention to leave surgical training?

    Science.gov (United States)

    Dominguez, Luis Carlos; Stassen, Laurents; de Grave, Willem; Sanabria, Alvaro; Alfonso, Edgar; Dolmans, Diana

    2018-01-01

    The intention to leave surgical training, hereinafter referred as proxy of "attrition," is associated with poor well-being in the workplace. Attrition is suggested to diminish when residents possess job-crafting skills, that is, the ability to redefine their job in meaningful ways and maximize well-being at work by increasing structural and social resources and challenges and decreasing hindering demands. However, the evidence supporting this relationship is scant. This study sought to: 1) investigate to what extent residents possess job-crafting skills and compare residents' levels of job-crafting skills across years of residency training; 2) investigate the relationship between job crafting, well-being as measured by burnout and work-engagement rates, and the intention to leave; and 3) compare the levels of job-crafting skills and well-being between residents with and without serious intentions to leave. This cross sectional study was conducted in fifteen residency programs in Colombia. Surgical residents completed different questionnaires including the Dutch Job Crafting Scale (DJCS), MBI-Human Services Survey (MBI-HSS), Utrecht Work Engagement Scale (UWES-17) and an adapted version of the Nurse Turnover Intention Scale (NTIS). The objectives were addressed by independent analyses of variance (ANOVA), structural equation modeling techniques (SEM) and independent t-tests, respectively. A total of 202 residents participated. Residents generally scored high on their job-crafting skills to increase structural and social resources as well as challenging demands, but were less positive about their skills to reduce hindering demands. No differences across years of training were found. Job crafting correlated positively with work-engagement, which was inversely related to the intention to leave. Conversely, job crafting correlated negatively with burnout, which bore a positive relationship to the intention to leave. Residents with serious intentions to leave exhibited

  16. Improving a bimanual motor skill through unimanual training

    Directory of Open Access Journals (Sweden)

    Takuji Hayashi

    2016-07-01

    Full Text Available When we learn a bimanual motor skill (e.g., rowing a boat, we often break it down into unimanual practices (e.g., a rowing drill with the left or right arm. Such unimanual practice is thought to be useful for learning bimanual motor skills efficiently because the learner can concentrate on learning to perform a simpler component. However, it is not so straightforward to assume that unimanual training improves bimanual performance. We have previously demonstrated that motor memories for reaching movements consist of 3 different parts: unimanual-specific, bimanual-specific, and overlapping parts. According to this scheme, unimanual training appears to be less effective, as its training effect is only partially transferred to the same limb for bimanual movement. In the present study, counter-intuitively, we demonstrate that, even after the bimanual skill is almost fully learned by means of bimanual training, additional unimanual training could further improve bimanual skill. We hypothesized that this effect occurs because unimanual training increases the memory content in the overlapping part, which might contribute to an increase in the memory for bimanual movement. To test this hypothesis, we examined whether the unimanual training performed after sufficient bimanual training could improve the bimanual performance. Participants practiced performing bimanual reaching movements in the presence of a novel force-field imposed only on their left arm. As an index for the motor performance, we used the error-clamp method (i.e., after-effect of the left arm to evaluate the force output to compensate for the force-field during the reaching movement. After sufficient bimanual training, the training effect reached a plateau. However, unimanual training performed subsequently improved the bimanual performance significantly. In contrast, when the same amount of bimanual training was continued, the bimanual performance remained unchanged, highlighting the

  17. Getting lost in translation? Workplace based assessments in surgical training.

    Science.gov (United States)

    Ali, Jason M

    2013-10-01

    Workplace based assessments (WBA) are integral to the competence-based surgical training curriculum that currently exists in the UK. The GMC emphasise the value of WBA's as assessments for learning (formative), rather than as assessments of learning (summative). Current implementation of WBA's in the workplace though, is at odds with their intended use, with the formative functions often being overlooked in favour of the summative, as exemplified by the recent announcement that trainees are required to complete a minimum of 40 WBA's a year, an increase from 24. Even before this increase, trainees viewed WBA's as tick-box exercises that negatively impact upon training opportunities. As a result, the tools are commonly misused, often because both trainees and trainers lack understanding of the benefits of full engagement with the formative learning opportunities afforded by WBA's. To aid the transition in mind-set of trainees and trainers to the purpose of assessment in the workplace, the GMC propose the introduction of 'supervised learning events' and 'assessments of performance' to supersede 'WBA's'. The impact of this change and how these will be integrated into surgical training is yet to be seen, but is likely to be a step in the right direction. Copyright © 2013 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  18. Training of troubleshooting skills in nuclear power plants

    International Nuclear Information System (INIS)

    Rhodes, W.; Szlapetis, I.J.; Casselman, K.

    1995-12-01

    This report details the study of training of troubleshooting skills for Canadian nuclear power plant operators and maintainers. The study was conducted in three distinct stages: 1) literature review and production of annotated bibliographies; 2) survey of experts in training for troubleshooting skills in North America; 3) survey of Canadian nuclear power plant training centres. Within this report are 12 annotated bibliographies of significant documents and an extensive bibliographic listing of relevant literature. The review of the literature and the survey of training experts identified the state-of-art in troubleshooting training with respect to training approaches and training tools. Trainers in the military, pharmaceutical, petro-chemical, and nuclear industries were surveyed and/or interviewed to determine the current approaches and technologies used in training for troubleshooting. Training personnel responsible for Canada's major nuclear generating stations (Bruce, Darlington, Pickering, and Point Lepreau) were interviewed and surveyed to determine the status of troubleshooting training in the Canadian nuclear industry. This information has been integrated and presented in this report. Conclusions and recommendations regarding the nature of the troubleshooting tasks performed by operators and maintainers and the related training were submitted. (author). 152 refs., 7 tabs., 1 fig

  19. Training of troubleshooting skills in nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Rhodes, W; Szlapetis, I J; Casselman, K [Rhodes and Associates, Inc., Willowdale, ON (Canada)

    1995-12-01

    This report details the study of training of troubleshooting skills for Canadian nuclear power plant operators and maintainers. The study was conducted in three distinct stages: (1) literature review and production of annotated bibliographies; (2) survey of experts in training for troubleshooting skills in North America; (3) survey of Canadian nuclear power plant training centres. Within this report are 12 annotated bibliographies of significant documents and an extensive bibliographic listing of relevant literature. The review of the literature and the survey of training experts identified the state-of-art in troubleshooting training with respect to training approaches and training tools. Trainers in the military, pharmaceutical, petro-chemical, and nuclear industries were surveyed and/or interviewed to determine the current approaches and technologies used in training for troubleshooting. Training personnel responsible for Canada`s major nuclear generating stations (Bruce, Darlington, Pickering, and Point Lepreau) were interviewed and surveyed to determine the status of troubleshooting training in the Canadian nuclear industry. This information has been integrated and presented in this report. Conclusions and recommendations regarding the nature of the troubleshooting tasks performed by operators and maintainers and the related training were submitted. (author). 152 refs., 7 tabs., 1 fig.

  20. 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.

  1. Examining the relationship between skilled music training and attention.

    Science.gov (United States)

    Wang, Xiao; Ossher, Lynn; Reuter-Lorenz, Patricia A

    2015-11-01

    While many aspects of cognition have been investigated in relation to skilled music training, surprisingly little work has examined the connection between music training and attentional abilities. The present study investigated the performance of skilled musicians on cognitively demanding sustained attention tasks, measuring both temporal and visual discrimination over a prolonged duration. Participants with extensive formal music training were found to have superior performance on a temporal discrimination task, but not a visual discrimination task, compared to participants with no music training. In addition, no differences were found between groups in vigilance decrement in either type of task. Although no differences were evident in vigilance per se, the results indicate that performance in an attention-demanding temporal discrimination task was superior in individuals with extensive music training. We speculate that this basic cognitive ability may contribute to advantages that musicians show in other cognitive measures. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Supplementing supported employment with workplace skills training.

    Science.gov (United States)

    Wallace, Charles J; Tauber, Robert

    2004-05-01

    Introduction by the column editors: Supported employment, as designed for persons with serious and persistent mental illness, has been termed individual placement and support. In two randomized controlled trials (1,2), clients who received individual placement and support services were more likely to obtain at least one job in the competitive sector, to work more hours, and to have a higher total income than their counterparts who received more traditional types of vocational rehabilitation. However, individual placement and support did not improve the length of time the employed participants kept their jobs. An adjunctive or additional element of individual placement and support, aimed at improving the job tenure of individuals with mental illness, would be a constructive contribution to the vocational rehabilitation for this population. In a previous Rehab Rounds column, Wallace and colleagues (3) described the development of the workplace fundamental skills module, a highly structured and user-friendly curriculum designed to teach workers with mental illness the social and workplace skills needed to keep their jobs. The workplace fundamental skills module supplements individual placement and support by conveying specific skills that enable workers to learn the requirements of their jobs, anticipate the stressors associated with their jobs, and cope with stressors by using a problem-solving process. The earlier report described the production and validation of the module's content. The purpose of this month's column is to present the preliminary results of a randomized comparison of the module's effects on job retention, symptoms, and community functioning when coupled with individual placement and support. To enable wide generalization of the findings of the study, the program was conducted in a typical community mental health center.

  3. Brief Report: Using Behavioral Skills Training to Teach Skateboarding Skills to a Child with Autism Spectrum Disorder

    Science.gov (United States)

    Thomas, Benjamin R.; Lafasakis, Michael; Spector, Vicki

    2016-01-01

    The aim of this study was to evaluate the effects of behavioral skills training (BST) on the skateboarding skills of an 11-year-old male with autism spectrum disorder (ASD). BST was used in a multiple-probe across skills design to teach five target skateboarding skills. Imitation of an additional skill was also assessed outside of BST sessions.…

  4. Gaze-contingent training enhances perceptual skill acquisition.

    Science.gov (United States)

    Ryu, Donghyun; Mann, David L; Abernethy, Bruce; Poolton, Jamie M

    2016-01-01

    The purpose of this study was to determine whether decision-making skill in perceptual-cognitive tasks could be enhanced using a training technique that impaired selective areas of the visual field. Recreational basketball players performed perceptual training over 3 days while viewing with a gaze-contingent manipulation that displayed either (a) a moving window (clear central and blurred peripheral vision), (b) a moving mask (blurred central and clear peripheral vision), or (c) full (unrestricted) vision. During the training, participants watched video clips of basketball play and at the conclusion of each clip made a decision about to which teammate the player in possession of the ball should pass. A further control group watched unrelated videos with full vision. The effects of training were assessed using separate tests of decision-making skill conducted in a pretest, posttest, and 2-week retention test. The accuracy of decision making was greater in the posttest than in the pretest for all three intervention groups when compared with the control group. Remarkably, training with blurred peripheral vision resulted in a further improvement in performance from posttest to retention test that was not apparent for the other groups. The type of training had no measurable impact on the visual search strategies of the participants, and so the training improvements appear to be grounded in changes in information pickup. The findings show that learning with impaired peripheral vision offers a promising form of training to support improvements in perceptual skill.

  5. Robotic surgical education: a collaborative approach to training postgraduate urologists and endourology fellows.

    Science.gov (United States)

    Mirheydar, Hossein; Jones, Marklyn; Koeneman, Kenneth S; Sweet, Robert M

    2009-01-01

    Currently, robotic training for inexperienced, practicing surgeons is primarily done vis-à-vis industry and/or society-sponsored day or weekend courses, with limited proctorship opportunities. The objective of this study was to assess the impact of an extended-proctorship program at up to 32 months of follow-up. An extended-proctorship program for robotic-assisted laparoscopic radical prostatectomy was established at our institution. The curriculum consisted of 3 phases: (1) completing an Intuitive Surgical 2-day robotic training course with company representatives; (2) serving as assistant to a trained proctor on 5 to 6 cases; and (3) performing proctored cases up to 1 year until confidence was achieved. Participants were surveyed and asked to evaluate on a 5-point Likert scale their operative experience in robotics and satisfaction regarding their training. Nine of 9 participants are currently performing robotic-assisted laparoscopic radical prostatectomy (RALP) independently. Graduates of our program have performed 477 RALP cases. The mean number of cases performed within phase 3 was 20.1 (range, 5 to 40) prior to independent practice. The program received a rating of 4.2/5 for effectiveness in teaching robotic surgery skills. Our robotic program, with extended proctoring, has led to an outstanding take-rate for disseminating robotic skills in a metropolitan community.

  6. Lack of transfer of skills after virtual reality simulator training with haptic feedback.

    Science.gov (United States)

    Våpenstad, Cecilie; Hofstad, Erlend Fagertun; Bø, Lars Eirik; Kuhry, Esther; Johnsen, Gjermund; Mårvik, Ronald; Langø, Thomas; Hernes, Toril Nagelhus

    2017-12-01

    Virtual reality (VR) simulators enrich surgical training and offer training possibilities outside of the operating room (OR). In this study, we created a criterion-based training program on a VR simulator with haptic feedback and tested it by comparing the performances of a simulator group against a control group. Medical students with no experience in laparoscopy were randomly assigned to a simulator group or a control group. In the simulator group, the candidates trained until they reached predefined criteria on the LapSim ® VR simulator (Surgical Science AB, Göteborg, Sweden) with haptic feedback (Xitact TM IHP, Mentice AB, Göteborg, Sweden). All candidates performed a cholecystectomy on a porcine organ model in a box trainer (the clinical setting). The performances were video rated by two surgeons blinded to subject training status. In total, 30 students performed the cholecystectomy and had their videos rated (N = 16 simulator group, N = 14 control group). The control group achieved better video rating scores than the simulator group (p training program did not transfer skills to the clinical setting. Poor mechanical performance of the simulated haptic feedback is believed to have resulted in a negative training effect.

  7. Hierarchy curriculum for practical skills training in optics and photonics

    Science.gov (United States)

    Zheng, XiaoDong; Wang, XiaoPing; Liu, Xu; Liu, XiangDong; Lin, YuanFang

    2017-08-01

    The employers in optical engineering fields hope to recruit students who are capable of applying optical principles to solve engineering problems and have strong laboratory skills. In Zhejiang University, a hierarchy curriculum for practical skill training has been constructed to satisfy this demand. This curriculum includes "Introductive practicum" for freshmen, "Opto-mechanical systems design", "Engineering training", "Electronic system design", "Student research training program (SRTP)", "National University Students' Optical-Science-Technology Competition game", and "Offcampus externship". Without cutting optical theory credit hours, this hierarchy curriculum provides a step-by-step solution to enhance students' practical skills. By following such a hierarchy curriculum, students can smoothly advance from a novice to a qualified professional expert in optics. They will be able to utilize optical engineering tools to design, build, analyze, improve, and test systems, and will be able to work effectively in teams to solve problems in engineering and design.

  8. Improving Creativity Training: A Study of Designer Skills

    DEFF Research Database (Denmark)

    Valgeirsdóttir, Dagný; Onarheim, Balder; Li-Ying, Jason

    2016-01-01

    and Cross2001]. Establishing that creativity is important for design and innovation implies that identifying ways of improving creativity is a relevant research area within design studies. Creativity is a basic human skill and multiple studies have been published showing that creativity is a skill that can...... be directed at the individual level by enhancing individual creativity skills, but also improvement at the team level, rendering it important to first improve the understanding of both these levels of creativity in the design process.There are multiple ways to train creativity, although currently most...... optimal way of training creativity is through a combination of (1) educating individuals about creativity, thereby building a solid theoretical understanding, and (2) providing them with a real world case where they are trained in the use of creative tools and processes[Scott et al. 2004]. The latter...

  9. Using Cognitive Agents to Train Negotiation Skills

    NARCIS (Netherlands)

    Stevens, Christopher A; Daamen, Jeroen; Gaudrain, Emma; Renkema, Tom; Top, Jakob Dirk; Cnossen, Fokie; Taatgen, Niels A

    2018-01-01

    Training negotiation is difficult because it is a complex, dynamic activity that involves multiple parties. It is often not clear how to create situations in which students can practice negotiation or how to measure students' progress. Some have begun to address these issues by creating artificial

  10. Virtual reality technology and surgical training--a survey of general surgeons in Ireland.

    Science.gov (United States)

    Early, S A; Roche-Nagle, G

    2006-01-01

    Virtual Reality Technology (VRT) is a validated method of training in industry but only recently has found a place in the postgraduate surgical curriculum. We surveyed 143 Irish consultant surgeons to ascertain their opinions on this topical issue. The survey consisted of 22 questions to which the consultants were asked to respond by choosing from a 5-point Likert scale. Sixty-five per cent responded. A majority of 72% had seen VRT but only 47% had 'hands on' experience. Forty-six per cent believed that they were poorly informed regarding available technologies. As consultants became more informed about VRT significant differences were seen with regard to attitudes regarding the role of VR in skills in surgical training (p<0.05) and in the ability to define teaching objectives (p<0.005). Our survey suggests that the underuse of the current offerings is not due to a perceived lack of interest on the part of the surgical trainers. Suppliers of these programmes have a responsibility to adequately educate and collaborate with all parties involved to improve overall benefit from these simulators.

  11. Augmented Reality Training for Assembly and Maintenance Skills

    Directory of Open Access Journals (Sweden)

    Preusche Carsten

    2011-12-01

    Full Text Available Augmented Reality (AR points out to be a good technology for training in the field of maintenance and assembly, as instructions or rather location-dependent information can be directly linked and/or attached to physical objects. Since objects to maintain usually contain a large number of similar components (e.g. screws, plugs, etc. the provision of location-dependent information is vitally important. Another advantage is that AR-based training takes place with the real physical devices of the training scenario. Thus, the trainee also practices the real use of the tools whereby the corresponding sensorimotor skills are trained.

  12. Measuring Nontechnical Aspects of Surgical Clinician Development in an Otolaryngology Residency Training Program.

    Science.gov (United States)

    Shin, Jennifer J; Cunningham, Michael J; Emerick, Kevin G; Gray, Stacey T

    2016-05-01

    Surgical competency requires sound clinical judgment, a systematic diagnostic approach, and integration of a wide variety of nontechnical skills. This more complex aspect of clinician development has traditionally been difficult to measure through standard assessment methods. This study was conducted to use the Clinical Practice Instrument (CPI) to measure nontechnical diagnostic and management skills during otolaryngology residency training; to determine whether there is demonstrable change in these skills between residents who are in postgraduate years (PGYs) 2, 4, and 5; and to evaluate whether results vary according to subspecialty topic or method of administration. Prospective study using the CPI, an instrument with previously established internal consistency, reproducibility, interrater reliability, discriminant validity, and responsiveness to change, in an otolaryngology residency training program. The CPI was used to evaluate progression in residents' ability to evaluate, diagnose, and manage case-based clinical scenarios. A total of 248 evaluations were performed in 45 otolaryngology resident trainees at regular intervals. Analysis of variance with nesting and postestimation pairwise comparisons were used to evaluate total and domain scores according to training level, subspecialty topic, and method of administration. Longitudinal residency educational initiative. Assessment with the CPI during PGYs 2, 4, and 5 of residency. Among the 45 otolaryngology residents (248 CPI administrations), there were a mean (SD) of 5 (3) administrations (range, 1-4) during their training. Total scores were significantly different among PGY levels of training, with lower scores seen in the PGY-2 level (44 [16]) compared with the PGY-4 (64 [13]) or PGY-5 level (69 [13]) (P otolaryngology (mean [SD], 72 [14]) than in subspecialties (range, 55 [12], P = .003, to 56 [19], P < .001). Neither administering the examination with an electronic scoring system, rather than a

  13. Training responsibly to improve global surgical and anaesthesia capacity through institutional health partnerships: a case study.

    Science.gov (United States)

    Macpherson, Laura; Collins, Maggie

    2017-01-01

    Urgent investment in human resources for surgical and anaesthesia care is needed globally. Responsible training and education is required to ensure healthcare providers are confident and skilled in the delivery of this care in both the rural and the urban setting. The Tropical Health and Education Trust (THET), a UK-based specialist global health organisation, is working with health training institutions, health professionals, Ministries of Health and Health Partnerships or 'links' between healthcare institutions in the UK and low- or middle-income country (LMIC) counterparts. These institutions may be hospitals, professional associations or universities whose primary focus is delivery of health services or the training and education of health workers. Since 2011, THET has been delivering the Health Partnership Scheme (HPS), a UK government-funded programme that provides grants and guidance to health partnerships and promotes the voluntary engagement of UK health professionals overseas. To date, the £30 million Scheme has supported peer-to-peer collaborations involving more than 200 UK and overseas hospitals, universities and professional associations across 25 countries in Africa, Asia and the Middle East. In this paper, we focus on four partnerships that are undertaking training initiatives focused on building capacity for surgery and anaesthesia. In order to do so, we discuss their role as a responsible and effective approach to harnessing the expertise available in the UK in order to increase surgical and anaesthesia capacity in LMICs. Specifically, how well they: (1) respond to locally identified needs; (2) are appropriate to the local context and are of high quality; and (3) have an overarching goal of making a sustainable contribution to the development of the health workforce through education and training. The HPS has now supported 24 training initiatives focused on building capacity for surgery and anaesthesia in 16 countries across sub-Saharan Africa

  14. 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

  15. Trained Inquiry Skills on Heat and Temperature Concepts

    Science.gov (United States)

    Hasanah, U.; Hamidah, I.; Utari, S.

    2017-09-01

    Inquiry skills are skills that aperson needs in developing concepts, but the results of the study suggest that these skills haven’t yet been trained along with the development of concepts in science feeding, found the difficulties of students in building the concept scientifically. Therefore, this study aims to find ways that are effective in training inquiry skills trough Levels of Inquiry (LoI) learning. Experimental research with one group pretest-postest design, using non-random sampling samples in one of vocational high school in Cimahi obtained purposively 33 students of X class. The research using the inquiry skills test instrument in the form of 15questions multiple choice with reliability in very high category. The result of data processing by using the normalized gain value obtained an illustration that the ways developed in the LoI are considered effective trained inquiry skills in the middle category. Some of the ways LoI learning are considered effective in communicating aspects through discovery learning, predicting trough interactive demonstration, hypotheses through inquiry lesson, and interpreting data through inquiry lab, but the implementation of LoI learning in this study hasn’t found a way that is seen as effective for trespassing aspects of designing an experiment.

  16. Cognitive skill training for nuclear power plant operational decision making

    Energy Technology Data Exchange (ETDEWEB)

    Mumaw, R.J.; Swatzler, D.; Roth, E.M. [Westinghouse Electric Corp., Pittsburgh, PA (United States); Thomas, W.A. [Quantum Technologies, Inc., Oak Brook, IL (United States)

    1994-06-01

    Training for operator and other technical positions in the commercial nuclear power industry traditionally has focused on mastery of the formal procedures used to control plant systems and processes. However, decisionmaking tasks required of nuclear power plant operators involve cognitive skills (e.g., situation assessment, planning). Cognitive skills are needed in situations where formal procedures may not exist or may not be as prescriptive, as is the case in severe accident management (SAM). The Westinghouse research team investigated the potential cognitive demands of SAM on the control room operators and Technical Support Center staff who would be most involved in the selection and execution of severe accident control actions. A model of decision making, organized around six general cognitive processes, was developed to identify the types of cognitive skills that may be needed for effective performance. Also, twelve SAM scenarios were developed to reveal specific decision-making difficulties. Following the identification of relevant cognitive skills, 19 approaches for training individual and team cognitive skills were identified. A review of these approaches resulted in the identification of general characteristics that are important in effective training of cognitive skills.

  17. Cognitive skill training for nuclear power plant operational decision making

    International Nuclear Information System (INIS)

    Mumaw, R.J.; Swatzler, D.; Roth, E.M.; Thomas, W.A.

    1994-06-01

    Training for operator and other technical positions in the commercial nuclear power industry traditionally has focused on mastery of the formal procedures used to control plant systems and processes. However, decisionmaking tasks required of nuclear power plant operators involve cognitive skills (e.g., situation assessment, planning). Cognitive skills are needed in situations where formal procedures may not exist or may not be as prescriptive, as is the case in severe accident management (SAM). The Westinghouse research team investigated the potential cognitive demands of SAM on the control room operators and Technical Support Center staff who would be most involved in the selection and execution of severe accident control actions. A model of decision making, organized around six general cognitive processes, was developed to identify the types of cognitive skills that may be needed for effective performance. Also, twelve SAM scenarios were developed to reveal specific decision-making difficulties. Following the identification of relevant cognitive skills, 19 approaches for training individual and team cognitive skills were identified. A review of these approaches resulted in the identification of general characteristics that are important in effective training of cognitive skills

  18. Hospital management training and improvement in managerial skills: Serbian experience.

    Science.gov (United States)

    Supic, Zorica Terzic; Bjegovic, Vesna; Marinkovic, Jelena; Milicevic, Milena Santric; Vasic, Vladimir

    2010-06-01

    The purpose of this study was to analyze the improvement of managerial skills of hospitals' top managers after a specific management training programme, and to explore possible predictors and relations. The study was conducted during the years 2006 and 2007 with cohort of 107 managers from 20 Serbian general hospitals. The managers self-assessed the improvement in their managerial skills before and after the training programme. After the training programme, all managers' skills had improved. The biggest improvement was in the following skills: organizing daily activities, motivating and guiding others, supervising the work of others, group discussion, and situation analysis. The least improved were: applying creative techniques, working well with peers, professional self-development, written communication, and operational planning. Identified predictors of improvement were: shorter years of managerial experience, type of manager, type of profession, and recognizing the importance of the managerial skills in oral communication, evidence-based decision making, and supervising the work of others. Specific training programme related to strategic management can increase managerial competencies, which are an important source of competitive advantage for organizations. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

    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.

  20. The laparoscopic surgical skills programme : Preliminary evaluation of grade I Level 1 courses by trainees

    NARCIS (Netherlands)

    Buzink, S.N.; Soltes, M.; Radonak, J.; Fingerhutt, A.; Hanna, G.; Jakimowicz, J.J.

    2012-01-01

    Introduction: New training models are needed to maintain safety and quality of surgical performance. A simulated setting using virtual reality, synthetic, and/or organic models should precede traditional supervised training in the operating room. Aim: The aim of the paper is to describe the

  1. Geritalk: Communication Skills Training for Geriatrics and Palliative Medicine Fellows

    Science.gov (United States)

    Kelley, Amy S.; Back, Anthony L.; Arnold, Robert M.; Goldberg, Gabrielle R.; Lim, Betty B.; Litrivis, Evgenia; Smith, Cardinale B.; O’Neill, Lynn B.

    2011-01-01

    Expert communication is essential to high quality care for older patients with serious illness. While the importance of communication skills is widely recognized, formal curricula for teaching communication skills to geriatrics and palliative medicine fellows is often inadequate or unavailable. We drew upon the educational principles and format of an evidence-based, interactive teaching method, to develop an intensive communication skills training course designed specifically to address the common communication challenges faced by geriatrics and palliative medicine fellows. The 2-day retreat, held away from the hospital environment, included large-group overview presentations, small-group communication skills practice, and development of future skills practice commitment. Faculty received in-depth training in small-group facilitation techniques prior to the course. Geriatrics and palliative medicine fellows were recruited to participate in the course and 100% (n=18) enrolled. Overall satisfaction with the course was very high (mean 4.8 on 5-point scale). Compared to before the course, fellows reported an increase in self-assessed preparedness for specific communication challenges (mean increase 1.4 on 5-point scale, pcommunication skills program, tailored to the specific needs of geriatrics and palliative medicine fellows, improved fellows’ self-assessed preparedness for challenging communication tasks and provided a model for ongoing deliberate practice of communication skills. PMID:22211768

  2. Prevalence and correlates of resistance training skill competence in adolescents.

    Science.gov (United States)

    Smith, Jordan J; DeMarco, Matthew; Kennedy, Sarah G; Kelson, Mark; Barnett, Lisa M; Faigenbaum, Avery D; Lubans, David R

    2018-06-01

    The aim of this study is to examine the prevalence and correlates of adolescents' resistance training (RT) skill competence. Participants were 548 adolescents (14.1 ± 0.5 years) from 16 schools in New South Wales, Australia. RT skills were assessed using the Resistance Training Skills Battery. Demographics, BMI, muscular fitness, perceived strength, RT self-efficacy, and motivation for RT were also assessed. The proportion demonstrating "competence" and "near competence" in each of the six RT skills were calculated and sex differences explored. Associations between the combined RT skill score and potential correlates were examined using multi-level linear mixed models. Overall, the prevalence of competence was low (range = 3.3% to 27.9%). Females outperformed males on the squat, lunge and overhead press, whereas males performed better on the push-up (p fitness was moderately and positively associated with RT skills among both males (β = 0.34, 95%CIs = 0.23 to 0.46) and females (β = 0.36, 95%CIs = 0.23 to 0.48). Our findings support a link between RT skills and muscular fitness. Other associations were statistically significant but small in magnitude, and should therefore be interpreted cautiously.

  3. Geritalk: communication skills training for geriatric and palliative medicine fellows.

    Science.gov (United States)

    Kelley, Amy S; Back, Anthony L; Arnold, Robert M; Goldberg, Gabrielle R; Lim, Betty B; Litrivis, Evgenia; Smith, Cardinale B; O'Neill, Lynn B

    2012-02-01

    Expert communication is essential to high-quality care for older patients with serious illness. Although the importance of communication skills is widely recognized, formal curricula for teaching communication skills to geriatric and palliative medicine fellows is often inadequate or unavailable. The current study drew upon the educational principles and format of an evidence-based, interactive teaching method to develop an intensive communication skills training course designed specifically to address the common communication challenges that geriatric and palliative medicine fellows face. The 2-day retreat, held away from the hospital environment, included large-group overview presentations, small-group communication skills practice, and development of future skills practice commitment. Faculty received in-depth training in small-group facilitation techniques before the course. Geriatric and palliative medicine fellows were recruited to participate in the course and 100% (n = 18) enrolled. Overall satisfaction with the course was very high (mean 4.8 on a 5-point scale). After the course, fellows reported an increase in self-assessed preparedness for specific communication challenges (mean increase 1.4 on 5-point scale, P communication skills program, customized for the specific needs of geriatric and palliative medicine fellows, improved fellows' self-assessed preparedness for challenging communication tasks and provided a model for ongoing deliberate practice of communication skills. © 2012, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.

  4. Training and Assessment of Hysteroscopic Skills: A Systematic Review.

    Science.gov (United States)

    Savran, Mona Meral; Sørensen, Stine Maya Dreier; Konge, Lars; Tolsgaard, Martin G; Bjerrum, Flemming

    2016-01-01

    The aim of this systematic review was to identify studies on hysteroscopic training and assessment. PubMed, Excerpta Medica, the Cochrane Library, and Web of Science were searched in January 2015. Manual screening of references and citation tracking were also performed. Studies on hysteroscopic educational interventions were selected without restrictions on study design, populations, language, or publication year. A qualitative data synthesis including the setting, study participants, training model, training characteristics, hysteroscopic skills, assessment parameters, and study outcomes was performed by 2 authors working independently. Effect sizes were calculated when possible. Overall, 2 raters independently evaluated sources of validity evidence supporting the outcomes of the hysteroscopy assessment tools. A total of 25 studies on hysteroscopy training were identified, of which 23 were performed in simulated settings. Overall, 10 studies used virtual-reality simulators and reported effect sizes for technical skills ranging from 0.31 to 2.65; 12 used inanimate models and reported effect sizes for technical skills ranging from 0.35 to 3.19. One study involved live animal models; 2 studies were performed in clinical settings. The validity evidence supporting the assessment tools used was low. Consensus between the 2 raters on the reported validity evidence was high (94%). This systematic review demonstrated large variations in the effect of different tools for hysteroscopy training. The validity evidence supporting the assessment of hysteroscopic skills was limited. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  5. Personal Skills. Facilitator's Skill Packets 1-7. Social Skills Training.

    Science.gov (United States)

    Model Classrooms, Bellevue, WA.

    This document contains the following seven facilitators' skill packets on personal skills: (1) personal hygiene; (2) personal appearance; (3) locker hygiene; (4) dorm cleanliness; (5) punctuality and attendance; (6) responding to supervision; and (7) teamwork. Each packet contains the following sections: definition of personal skills; objective;…

  6. 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.

  7. Quiet eye training improves surgical knot tying more than traditional technical training: a randomized controlled study.

    Science.gov (United States)

    Causer, Joe; Harvey, Adrian; Snelgrove, Ryan; Arsenault, Gina; Vickers, Joan N

    2014-08-01

    We examined the effectiveness of technical training (TT) and quiet eye training (QE) on the performance of one-handed square knot tying in surgical residents. Twenty surgical residents were randomly assigned to the 2 groups and completed pretest, training, retention, and transfer tests. Participants wore a mobile eye tracker that simultaneously recorded their gaze and hand movements. Dependent variables were knot tying performance (%), QE duration (%), number of fixations, total movement time (s), and hand movement phase time (s). The QE training group had significantly higher performance scores, a longer QE duration, fewer fixations, faster total knot tying times, and faster movement phase times compared with the TT group. The QE group maintained performance in the transfer test, whereas the TT group significantly decreased performance from retention to transfer. QE training significantly improved learning, retention, and transfer of surgical knot tying compared with a traditional technical approach. Both performance effectiveness (performance outcome) and movement efficiency (hand movement times) were improved using QE modeling, instruction, and feedback. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Communication Skills Training for Physicians Improves Patient Satisfaction.

    Science.gov (United States)

    Boissy, Adrienne; Windover, Amy K; Bokar, Dan; Karafa, Matthew; Neuendorf, Katie; Frankel, Richard M; Merlino, James; Rothberg, Michael B

    2016-07-01

    Skilled physician communication is a key component of patient experience. Large-scale studies of exposure to communication skills training and its impact on patient satisfaction have not been conducted. We aimed to examine the impact of experiential relationship-centered physician communication skills training on patient satisfaction and physician experience. This was an observational study. The study was conducted at a large, multispecialty academic medical center. Participants included 1537 attending physicians who participated in, and 1951 physicians who did not participate in, communication skills training between 1 August 2013 and 30 April 2014. An 8-h block of interactive didactics, live or video skill demonstrations, and small group and large group skills practice sessions using a relationship-centered model. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CGCAHPS), Jefferson Scale of Empathy (JSE), Maslach Burnout Inventory (MBI), self-efficacy, and post course satisfaction. Following the course, adjusted overall CGCAHPS scores for physician communication were higher for intervention physicians than for controls (92.09 vs. 91.09, p communication scores (83.95 vs. 82.73, p = 0.22). Physicians reported high course satisfaction and showed significant improvement in empathy (116.4 ± 12.7 vs. 124 ± 11.9, p communication skills training improved patient satisfaction scores, improved physician empathy, self-efficacy, and reduced physician burnout. Further research is necessary to examine longer-term sustainability of such interventions.

  9. Upgrade and interpersonal skills training at American Airlines

    Science.gov (United States)

    Estridge, W. W.; Mansfield, J. L.

    1980-01-01

    Segments of the interpersonal skills training audio visual program are presented. The program was developed to train customer contact personnel with specific emphasis on transactional analysis in customer treatment. Concepts of transactional analysis are summarized in terms of the make up of the personality, identified as the three ego states. These ego states are identified as the parent, the adult, and the child. Synopses of four of the tape programs are given.

  10. Automated Motor Skills Training Optimized for Individual Differences.

    Science.gov (United States)

    1980-11-01

    Several preliminary applications of adaptive training to I complex synthetic flight trainers have been attempted (Loses, I ,5 I Ellis, Norman , and Matheny...Association, San Francisco, 1976. Lowes, A. H., Ellis, N. C., Norman , D. A., and Matheny, W. 3. Improving piloting skills in turbulent air using a self...intercept observer. Orlando, Florida: Naval Training Equipment Center, NAVTRAEQUIPCEN 71-C-6219-1, 1973. Smallwood , R. D. A decision structure for

  11. 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.

  12. Applied Research on Laparoscopic Simulator in the Resident Surgical Laparoscopic Operation Technical Training.

    Science.gov (United States)

    Fu, Shangxi; Liu, Xiao; Zhou, Li; Zhou, Meisheng; Wang, Liming

    2017-08-01

    The purpose of this study was to estimate the effects of surgical laparoscopic operation course on laparoscopic operation skills after the simulated training for medical students with relatively objective results via data gained before and after the practice course of laparoscopic simulator of the resident standardized trainees. Experiment 1: 20 resident standardized trainees with no experience in laparoscopic surgery were included in the inexperienced group and finished simulated cholecystectomy according to simulator videos. Simulator data was collected (total operation time, path length, average speed of instrument movement, movement efficiency, number of perforations, the time cautery is applied without appropriate contact with adhesions, number of serious complications). Ten attending doctors were included in the experienced group and conducted the operation of simulated cholecystectomy directly. Data was collected with simulator. Data of two groups was compared. Experiment 2: Participants in inexperienced group were assigned to basic group (receiving 8 items of basic operation training) and special group (receiving 8 items of basic operation training and 4 items of specialized training), and 10 persons for each group. They received training course designed by us respectively. After training level had reached the expected target, simulated cholecystectomy was performed, and data was collected. Experimental data between basic group and special group was compared and then data between special group and experienced group was compared. Results of experiment 1 showed that there is significant difference between data in inexperienced group in which participants operated simulated cholecystectomy only according to instructors' teaching and operation video and data in experienced group. Result of experiment 2 suggested that, total operation time, number of perforations, number of serious complications, number of non-cauterized bleeding and the time cautery is applied

  13. Transfer of Skills Evaluation for Assembly and Maintenance Training

    Directory of Open Access Journals (Sweden)

    Peveri Matteo

    2011-12-01

    Full Text Available One of the research topics within the EU-project SKILLS1 was the training of Industrial Maintenance and Assembly (IMA tasks. The IMA demonstrator developed comprehends two different training platforms, one based on technologies of Virtual Reality (VR and the other one on Augmented Reality (AR. To qualify the efficiency of the developed training systems different studies have been conducted, followed by a final “Transfer of Skill” evaluation that has been performed by service technicians at the “SIDEL industrial training centre” in Parma. This evaluation included qualitative methods (feedback collection in questionnaires as well as quantitative methods (experiments with control groups. The results demonstrate that both platforms are useful and suitable training tools for IMA tasks, and that the AR training decreased the number of unsolved errors in the task.

  14. Simulation-based interpersonal communication skills training for neurosurgical residents.

    Science.gov (United States)

    Harnof, Sagi; Hadani, Moshe; Ziv, Amitai; Berkenstadt, Haim

    2013-09-01

    Communication skills are an important component of the neurosurgery residency training program. We developed a simulation-based training module for neurosurgery residents in which medical, communication and ethical dilemmas are presented by role-playing actors. To assess the first national simulation-based communication skills training for neurosurgical residents. Eight scenarios covering different aspects of neurosurgery were developed by our team: (1) obtaining informed consent for an elective surgery, (2) discharge of a patient following elective surgery, (3) dealing with an unsatisfied patient, (4) delivering news of intraoperative complications, (5) delivering news of a brain tumor to parents of a 5 year old boy, (6) delivering news of brain death to a family member, (7) obtaining informed consent for urgent surgery from the grandfather of a 7 year old boy with an epidural hematoma, and (8) dealing with a case of child abuse. Fifteen neurosurgery residents from all major medical centers in Israel participated in the training. The session was recorded on video and was followed by videotaped debriefing by a senior neurosurgeon and communication expert and by feedback questionnaires. All trainees participated in two scenarios and observed another two. Participants largely agreed that the actors simulating patients represented real patients and family members and that the videotaped debriefing contributed to the teaching of professional skills. Simulation-based communication skill training is effective, and together with thorough debriefing is an excellent learning and practical method for imparting communication skills to neurosurgery residents. Such simulation-based training will ultimately be part of the national residency program.

  15. Using Cognitive Agents to Train Negotiation Skills

    Directory of Open Access Journals (Sweden)

    Christopher A. Stevens

    2018-02-01

    Full Text Available Training negotiation is difficult because it is a complex, dynamic activity that involves multiple parties. It is often not clear how to create situations in which students can practice negotiation or how to measure students' progress. Some have begun to address these issues by creating artificial software agents with which students can train. These agents have the advantage that they can be “reset,” and played against multiple times. This allows students to learn from their mistakes and try different strategies. However, these agents are often based on normative theories of how negotiators should conduct themselves, not necessarily how people actually behave in negotiations. Here, we take a step toward addressing this gap by developing an agent grounded in a cognitive architecture, ACT-R. This agent contains a model of theory-of-mind, the ability of humans to reason about the mental states of others. It uses this model to try to infer the strategy of the opponent and respond accordingly. In a series of experiments, we show that this agent replicates some aspects of human performance, is plausible to human negotiators, and can lead to learning gains in a small-scale negotiation task.

  16. Using Cognitive Agents to Train Negotiation Skills.

    Science.gov (United States)

    Stevens, Christopher A; Daamen, Jeroen; Gaudrain, Emma; Renkema, Tom; Top, Jakob Dirk; Cnossen, Fokie; Taatgen, Niels A

    2018-01-01

    Training negotiation is difficult because it is a complex, dynamic activity that involves multiple parties. It is often not clear how to create situations in which students can practice negotiation or how to measure students' progress. Some have begun to address these issues by creating artificial software agents with which students can train. These agents have the advantage that they can be "reset," and played against multiple times. This allows students to learn from their mistakes and try different strategies. However, these agents are often based on normative theories of how negotiators should conduct themselves, not necessarily how people actually behave in negotiations. Here, we take a step toward addressing this gap by developing an agent grounded in a cognitive architecture, ACT-R. This agent contains a model of theory-of-mind, the ability of humans to reason about the mental states of others. It uses this model to try to infer the strategy of the opponent and respond accordingly. In a series of experiments, we show that this agent replicates some aspects of human performance, is plausible to human negotiators, and can lead to learning gains in a small-scale negotiation task.

  17. Communication skills training: describing a new conceptual model.

    Science.gov (United States)

    Brown, Richard F; Bylund, Carma L

    2008-01-01

    Current research in communication in physician-patient consultations is multidisciplinary and multimethodological. As this research has progressed, a considerable body of evidence on the best practices in physician-patient communication has been amassed. This evidence provides a foundation for communication skills training (CST) at all levels of medical education. Although the CST literature has demonstrated that communication skills can be taught, one critique of this literature is that it is not always clear which skills are being taught and whether those skills are matched with those being assessed. The Memorial Sloan-Kettering Cancer Center Comskil Model for CST seeks to answer those critiques by explicitly defining the important components of a consultation, based on Goals, Plans, and Actions theories and sociolinguistic theory. Sequenced guidelines as a mechanism for teaching about particular communication challenges are adapted from these other methods. The authors propose that consultation communication can be guided by an overarching goal, which is achieved through the use of a set of predetermined strategies. Strategies are common in CST; however, strategies often contain embedded communication skills. These skills can exist across strategies, and the Comskil Model seeks to make them explicit in these contexts. Separate from the skills are process tasks and cognitive appraisals that need to be addressed in teaching. The authors also describe how assessment practices foster concordance between skills taught and those assessed through careful coding of trainees' communication encounters and direct feedback.

  18. Performance on a Surgical In-Training Examination Varies by Training Year and Pathway.

    Science.gov (United States)

    Silvestre, Jason; Levin, L Scott; Serletti, Joseph M; Chang, Benjamin

    2016-08-01

    Few studies in surgery have addressed medical knowledge competency training as defined by the Accreditation Council for Graduate Medical Education. As in-training examinations are ubiquitous educational tools for surgical residents in the United States, insights into examination performance may help fill this void. The purpose of this study was to determine the relationship between In-Service Examination performance and training characteristics in plastic surgery. This retrospective cohort study reviewed performance data for the Plastic Surgery In-Service Training Examination for the years 2012 to 2015. Comparisons were made both within and between training pathways by means of Kruskal-Wallis and Mann-Whitney U tests. Data were available for 1367 independent (37.9 percent) and 2240 integrated residents (62.1 percent). Among integrated residents, performance increased with additional years of training (p 0.05). Similarly, independent resident examination performance increased by year of training (p 0.05). At each level of training (postgraduate years 4 to 6), integrated residents outperformed their independent resident colleagues (postgraduate years 1 to 3) (p < 0.001). Performance on the Plastic Surgery In-Service Training Examination increases during residency, with integrated residents outperforming independent residents. These findings may have implications for medical knowledge competency training as defined by the Accreditation Council for Graduate Medical Education.

  19. 3D-printed pediatric endoscopic ear surgery simulator for surgical training.

    Science.gov (United States)

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

    2016-11-01

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

  20. Non-technical skills training to enhance patient safety.

    Science.gov (United States)

    Gordon, Morris

    2013-06-01

      Patient safety is an increasingly recognised issue in health care. Systems-based and organisational methods of quality improvement, as well as education focusing on key clinical areas, are common, but there are few reports of educational interventions that focus on non-technical skills to address human factor sources of error. A flexible model for non-technical skills training for health care professionals has been designed based on the best available evidence, and with sound theoretical foundations.   Educational sessions to improve non-technical skills in health care have been described before. The descriptions lack the details to allow educators to replicate and innovate further.   A non-technical skills training course that can be delivered as either a half- or full-day intervention has been designed and delivered to a number of mixed groups of undergraduate medical students and doctors in postgraduate training. Participant satisfaction has been high and patient safety attitudes have improved post-intervention.   This non-technical skills educational intervention has been built on a sound evidence base, and is described so as to facilitate replication and dissemination. With the key themes laid out, clinical educators will be able to build interventions focused on numerous clinical issues that pay attention to human factor contributors to safety. © 2013 John Wiley & Sons Ltd.

  1. 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.

  2. Surgical Thoracic Transplant Training: Super Fellowship-Is It Super?

    Science.gov (United States)

    Makdisi, George; Makdisi, Tony; Caldeira, Christiano C; Wang, I-Wen

    2017-10-11

    The quality of training provided to thoracic transplant fellows is a critical step in the care of complex patients undergoing transplant. The training varies since it is not an accreditation council for graduate medical education accredited fellowship. A total of 104 heart or lung transplant program directors throughout the United States were sent a survey of 24 questions focusing on key aspects of training, fellowship training content and thoracic transplant job satisfaction. Out of the 104 programs surveyed 45 surveys (43%) were returned. In total, 26 programs offering a transplant fellowship were included in the survey. Among these programs 69% currently have fellows of which 56% are American Board of Thoracic Surgery board eligible. According to the United Network for Organ Sharing (UNOS) requirements, 46% of the programs do not meet the requirements to be qualified as a primary heart transplant surgeon. A total of 23% of lung transplant programs also perform less than the UNOS minimum requirements. Only 24% have extra-surgical curriculum. Out of the participating programs, only 38% of fellows secured a job in a hospital setting for performing transplants. An astounding 77% of replies site an unpredictable work schedule as the main reason that makes thoracic transplant a less than favorable profession among new graduates. Long hours were also a complaint of 69% of graduates who agreed that their personal life is affected by excessive work hours. Annually, almost half of all thoracic transplant programs perform fewer than the UNOS requirements to be a primary thoracic surgeon. This results in a majority of transplant fellows not finding a suitable transplant career. The current and future needs for highly qualified thoracic transplant surgeons will not be met through our existing training mechanisms. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  3. Social skills training with early adolescents : Effects on social skills, well-being, self-esteem and coping

    NARCIS (Netherlands)

    Bijstra, J.O.; Jackson, A.E.

    1998-01-01

    This study discusses the educational effects of a social skills training on adolescents' social skills, self-esteem, well-being and coping. A group of 14- to 16-year-old normal adolescents followed a social skills training based on social learning principles. A pre-tear experiment - post-test design

  4. Integrated surgical academic training in the UK: a cross-sectional survey.

    Science.gov (United States)

    Blencowe, Natalie S; Glasbey, James C; McElnay, Philip J; Bhangu, Aneel; Gokani, Vimal J; Harries, Rhiannon L

    2017-10-01

    This study aimed to explore variations in the provision of integrated academic surgical training across the UK. This is an online cross-sectional survey (consisting of 44 items with a range of free-text, binomial and 5-point Likert scale responses) developed by the Association of Surgeons in Training. A self-reported survey instrument was distributed to academic surgical trainees across the UK (n=276). 143 (51.9%) responses were received (81% male, median age: 34 years), spanning all UK regions and surgical specialties. Of the 143 trainees, 29 were core trainees (20.3%), 99 were specialty trainees (69.2%) and 15 (10.5%) described themselves as research fellows. The structure of academic training varied considerably, with under a third of trainees receiving guaranteed protected time for research. Despite this, however, 53.1% of the respondents reported to be satisfied with how their academic training was organised. Covering clinical duties during academic time occurred commonly (72.7%). Although most trainees (n=88, 61.5%) met with their academic supervisor at least once a month, six (4.2%) never had an academic supervisory meeting. Most trainees (n=90, 62.9%) occupied a full-time rota slot and only 9.1% (n=13) described their role as 'supernumerary'. Although 58.7% (n=84) of the trainees were satisfied with their clinical competence, 37.8% (n=54) felt that clinical time focused more on service provision than the acquisition of technical skills. 58 (40.6%) had experienced some form of negative sentiment relating to their status as an academic trainee. Integrated academic training presents unique challenges and opportunities within surgery. This survey has identified variation in the quality of current programmes, meaning that the future provision of integrated surgical academic training should be carefully considered. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is

  5. Counselling Communication Skills: Its Place In The Training ...

    African Journals Online (AJOL)

    This article overviews three extremely important skills within the training of a counselling psychologist environment: active listening, use of questions and silences. It is now a well-established and widely accepted concept that counselling plays a central role in the development of an individual. Counselling is a specialist ...

  6. Relevance of Technical Training Institutions Taught Skills to Current ...

    African Journals Online (AJOL)

    Technical education in Kenya is a necessary condition that enables members of society to productively function in technologically rapidly changing society. Technical training institutions have the responsibility to develop skilled Artisans, Craftsmen and Technician for employment in business organizations and industries.

  7. Skills training workshops as a viable strategy for improving ...

    African Journals Online (AJOL)

    Skills training workshops as a viable strategy for improving smallholder and cooperative agribusiness management: A case study of Vhembe District, Limpopo Province, South Africa. ... South African Journal of Agricultural Extension ... Empirical evidence from this study shows that six months after attending the workshops, ...

  8. Training Phoneme Blending Skills in Children with Down Syndrome

    Science.gov (United States)

    Burgoyne, Kelly; Duff, Fiona; Snowling, Maggie; Buckley, Sue; Hulme, Charles

    2013-01-01

    This article reports the evaluation of a 6-week programme of teaching designed to support the development of phoneme blending skills in children with Down syndrome (DS). Teaching assistants (TAs) were trained to deliver the intervention to individual children in daily 10-15-minute sessions, within a broader context of reading and language…

  9. Social skills training for juvenile delinquents : post-treatment changes

    NARCIS (Netherlands)

    van der Stouwe, Trudy; Asscher, Jessica J.; Hoeve, Machteld; van der Laan, Peter H.; Stams, Geert Jan J M

    2016-01-01

    Objectives: To examine the post-treatment effectiveness of an outpatient, individual social skills training for juvenile delinquents in the Netherlands and to conduct moderator tests for age, gender, ethnicity, and risk of reoffending. Methods: The sample consisted of juveniles who received Tools4U,

  10. Social Skills Training for Juvenile Delinquents: Post-Treatment Changes

    NARCIS (Netherlands)

    van der Stouwe, Trudy; Asscher, J.J.; Stams, G.J.J.M.; Hoeve, M.; van der Laan, Peter H.

    2016-01-01

    Objectives: To examine the post-treatment effectiveness of an outpatient, individual social skills training for juvenile delinquents in the Netherlands and to conduct moderator tests for age, gender, ethnicity, and risk of reoffending. Methods: The sample consisted of juveniles who received Tools4U,

  11. Social skills training for juvenile delinquents : Post-treatment changes

    NARCIS (Netherlands)

    van der Stouwe, T.; Asscher, J.J.; Hoeve, M.; van der Laan, P.H.; Stams, G.J.J.M.

    2016-01-01

    Objectives To examine the post-treatment effectiveness of an outpatient, individual social skills training for juvenile delinquents in the Netherlands and to conduct moderator tests for age, gender, ethnicity, and risk of reoffending. Methods The sample consisted of juveniles who received Tools4U, a

  12. Measuring Effects of a Skills Training Intervention for Drug Abusers.

    Science.gov (United States)

    Hawkins, J. David; And Others

    1986-01-01

    A test was conducted of a supplemental skills training and social-network-development aftercare program with 130 drug abusers from four residential therapeutic communities. The intervention produced positive effects on subjects' performance at the conclusion of treatment. Performance improved in situations involving avoidance of drug use, coping…

  13. Guidelines for Training in Advanced Gestalt Therapy Skills.

    Science.gov (United States)

    Holiman, Marjorie; Engle, David

    1989-01-01

    Describes guidelines for gestalt training emphasizing observation of novice and expert therapists, opportunities to practice skills, and procedures to provide trainees with immediate feedback. Claims three methods of evaluation are useful to trainees: publicly monitoring progress; increasing specificity of feedback; and helping trainees to…

  14. The training of coaching skills: An implementation study

    NARCIS (Netherlands)

    Veenman, S.

    1995-01-01

    In this study, the implementation effects of a programme for the training of coaching skills with Dutch school counsellors are described. These school counsellors are expected to provide help and support to primary school teachers. Coaching is a form of in-class support intended to provide teachers

  15. Effects of visual skills training, vision coaching and sports vision ...

    African Journals Online (AJOL)

    The purpose of this study was to determine the effectiveness of three different approaches to improving sports performance through improvements in “sports vision:” (1) a visual skills training programme, (2) traditional vision coaching sessions, and (3) a multi-disciplinary approach identified as sports vision dynamics.

  16. Cooperative Learning and Soft Skills Training in an IT Course

    Science.gov (United States)

    Zhang, Aimao

    2012-01-01

    Pedagogy of higher education is shifting from passive to active and deep learning. At the same time, the information technology (IT) industry and the Accreditation Board for Engineering and Technology (ABET) are demanding soft skills training. Thus, in designing an IT course, we devised group teaching projects where students learn to work with…

  17. Effect of simulated emergency skills training and assessments on ...

    African Journals Online (AJOL)

    ... of emergency skills in simulation was highly effective in enhancing the competence and confidence of medical students when managing a clinical emergency. However, students appeared to be overconfident, which could be ascribed to ignorance, and possibly indicates that feedback during training should be improved.

  18. Training Tools for Nontechnical Skills for Surgeons-A Systematic Review.

    Science.gov (United States)

    Wood, Thomas Charles; Raison, Nicholas; Haldar, Shreya; Brunckhorst, Oliver; McIlhenny, Craig; Dasgupta, Prokar; Ahmed, Kamran

    Development of nontechnical skills for surgeons has been recognized as an important factor in surgical care. Training tools for this specific domain are being created and validated to maximize the surgeon's nontechnical ability. This systematic review aims to outline, address, and recommend these training tools. A full and comprehensive literature search, using a systematic format, was performed on ScienceDirect and PubMed, with data extraction occurring in line with specified inclusion criteria. Systematic review was performed fully at King's College London. A total of 84 heterogeneous articles were used in this review. Further, 23 training tools including scoring systems, training programs, and mixtures of the two for a range of specialities were identified in the literature. Most can be applied to surgery overall, although some tools target specific specialities (such as neurosurgery). Interrater reliability, construct, content, and face validation statuses were variable according to the specific tool in question. Study results pertaining to nontechnical skill training tools have thus far been universally positive, but further studies are required for those more recently developed and less extensively used tools. Recommendations can be made for individual training tools based on their level of validation and for their target audience. Based on the number of studies performed and their status of validity, NOTSS and Oxford NOTECHS II can be considered the gold standard for individual- and team-based nontechnical skills training, respectively, especially when used in conjunction with a training program. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. Simulation-Based Laparoscopic Surgery Crisis Resource Management Training-Predicting Technical and Nontechnical Skills.

    Science.gov (United States)

    Goldenberg, Mitchell G; Fok, Kai H; Ordon, Michael; Pace, Kenneth T; Lee, Jason Y

    2017-12-19

    To develop a unique simulation-based assessment using a laparoscopic inferior vena cava (IVC) injury scenario that allows for the safe assessment of urology resident's technical and nontechnical skills, and investigate the effect of personality traits performance in a surgical crisis. Urology residents from our institution were recruited to participate in a simulation-based training laparoscopic nephrectomy exercise. Residents completed demographic and multidimensional personality questionnaires and were instructed to play the role of staff urologist. A vasovagal response to pneumoperitoneum and an IVC injury event were scripted into the scenario. Technical and nontechnical skills were assessed by expert laparoscopic surgeons using validated tools (task checklist, GOALS, and NOTSS). Ten junior and five senior urology residents participated. Five residents were unable to complete the exercise safely. Senior residents outperformed juniors on technical (checklist score 15.1 vs 9.9, p Technical performance scores correlated with NOTSS scores (p technical performance (p technical score (p = 0.03) and pass/fail rating (p = 0.04). Resident level of training and laparoscopic experience correlated with technical performance during a simulation-based laparoscopic IVC injury crisis management scenario, as well as multiple domains of nontechnical performance. Personality traits of our surgical residents are similar and did not predict technical skill. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  20. 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.

  1. Behavioral Skills Training in Portuguese Children With School Failure Problems

    Directory of Open Access Journals (Sweden)

    Edgar Galindo

    2018-05-01

    Full Text Available This paper postulates that psychology can make an important contribution at an individual level to help children with school failure problems in a context where too little applied research has been conducted on the instructional needs of these children. Some data are analyzed, revealing that, despite some progress, school failure is still a main educational problem in many countries. In this study, Behavioral Skills Training (BST was applied in Portugal to train children with school failure difficulties. BST is a method based on Applied Behavior Analysis, a teaching package consisting of a combination of behavioral techniques: instructions, modeling, rehearsal, and feedback. Two empirical studies are presented. Their main purpose was to develop behavioral diagnostic and training techniques to teach lacking skills. School success was defined in terms of a set of skills proposed by teachers and school failure as a lack of one or more of these skills. The main instrument was a package of training programs to be applied in three areas: basic behavior (precurrents, academic behavior, or social behavior. The second instrument is a package of check-lists, aimed to determine the level of performance of the child in an area. This check-list was applied before (pre-test and after (post-test training. In the first study, 16, 7- to 8-year old children were trained. They were attending the second or third grades and having academic difficulties of different origins. The effects of the training programs are evaluated in terms of percentage of attained objectives, comparing a pre- and a post-test. The results showed an increase in correct responses after training in all cases. To provide a sounder demonstration of the efficacy of the training programs, a second study was carried out using a quasi-experimental design. A multiple baseline design was applied to three 10- to 11-year-old children, referred by teachers because of learning difficulties in the fourth

  2. Embracing Errors in Simulation-Based Training: The Effect of Error Training on Retention and Transfer of Central Venous Catheter Skills.

    Science.gov (United States)

    Gardner, Aimee K; Abdelfattah, Kareem; Wiersch, John; Ahmed, Rami A; Willis, Ross E

    2015-01-01

    Error management training is an approach that encourages exposure to errors during initial skill acquisition so that learners can be equipped with important error identification, management, and metacognitive skills. The purpose of this study was to determine how an error-focused training program affected performance, retention, and transfer of central venous catheter (CVC) placement skills when compared with traditional training methodologies. Surgical interns (N = 30) participated in a 1-hour session featuring an instructional video and practice performing internal jugular (IJ) and subclavian (SC) CVC placement with guided instruction. All interns underwent baseline knowledge and skill assessment for IJ and SC (pretest) CVC placement; watched a "correct-only" (CO) or "correct + error" (CE) instructional video; practiced for 30 minutes; and were posttested on knowledge and IJ and SC CVC placement. Skill retention and transfer (femoral CVC placement) were assessed 30 days later. All skills tests (pretest, posttest, and transfer) were videorecorded and deidentified for evaluation by a single blinded instructor using a validated 17-item checklist. Both the groups exhibited significant improvements (p error-based activities and discussions into training programs can be beneficial for skill retention and transfer. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  3. [Skills Training for Patients with Borderline Personality Disorder].

    Science.gov (United States)

    Armbrust, Michael; Ehrig, Christian

    2016-07-01

    The emotionally instable personality disorder, mostly called borderline disorder, shows central abnormalities in impulse control as well as instability of mood and identity. It is composed of behaviour problems in creating relationships and in self-management, first of all by high psychophysiological tension. The prevalence of this disorder is 10 % in outpatients and 20 % in inpatients and has therefore high relevance for the medical-psychotherapeutic care system. The treatment is deemed to be complex and interminable. Regarding all evaluated techniques of treatment the best examined is the Dialectical Behavioral Therapy (DBT). This specific therapy, developed in the eighties by Marsha M. Linehan, can be used for inpatient and outpatient treatment and combines single and group sessions. It is essential in mental health care of this disorder, but not available everywhere. Essential part of DBT is the skill training, a specific technique for the acquirement and for exercising skills for mindfulness, modulation of tension, regulation of emotions, structuring of social competence and developing self value. The central goal of DBT is to ensure the survival of the patients, to reduce self- and external aggressive behaviour and to provide inpatient crisis interventions. For sustained crisis management skills for reality acceptance are best fitting. But before, fast available sensory and active body-related skills should be used. Radical acceptance is the most important, since most effective, skill. The skills training, although in use for only twenty years, is permanently expanding in practice and is meanwhile also used for other disorders such as, for example, PTSD or ADHD. Since 2010, there also exists an elaborated DBT-version for adolescents. For medical care politics and health-economic reasons a supply with skills training for in- and outpatients all over the country is desirable. © Georg Thieme Verlag KG Stuttgart · New York.

  4. A management framework for training providers to improve skills development in the workplace

    OpenAIRE

    2011-01-01

    D.Ed. A skills revolution was launched in the South African workplace by the Department of Labour in 1998. Various skills development legislation were introduced to meet international standards, redress skills imbalances, curb skills shortages and improve the general skills in the current workforce. Training providers were the drivers of workplace training, yet are now displaced by skills authorities, such as the SET As, the ETQAs and SAQA. While the custody of skills development is placed...

  5. Training Methods to Improve Evidence-Based Medicine Skills

    Directory of Open Access Journals (Sweden)

    Filiz Ozyigit

    2010-06-01

    Full Text Available Evidence based medicine (EBM is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. It is estimated that only 15% of medical interventions is evidence-based. Increasing demand, new technological developments, malpractice legislations, a very speed increase in knowledge and knowledge sources push the physicians forward for EBM, but at the same time increase load of physicians by giving them the responsibility to improve their skills. Clinical maneuvers are needed more, as the number of clinical trials and observational studies increase. However, many of the physicians, who are in front row of patient care do not use this increasing evidence. There are several examples related to different training methods in order to improve skills of physicians for evidence based practice. There are many training methods to improve EBM skills and these trainings might be given during medical school, during residency or as continuous trainings to the actual practitioners in the field. It is important to discuss these different training methods in our country as well and encourage dissemination of feasible and effective methods. [TAF Prev Med Bull 2010; 9(3.000: 245-254

  6. Feasibility Pilot Study: Training Soft Skills in Virtual Worlds.

    Science.gov (United States)

    Abshier, Patricia

    2012-04-01

    In a world where funding is limited, training for healthcare professionals is turning more and more to distance learning in an effort to maintain a knowledgeable and skilled work force. In 2010, Cicatelli Associates, Inc. began exploring the feasibility of using games and virtual worlds as an alternative means to teach skills-training in a distance-learning environment. The pilot study was conducted with six individuals familiar with general counseling and communication skills used by the healthcare industry to promote behavior change. Participants reported that the venue, although challenging at first, showed great potential for use with healthcare providers, as it allowed for more interaction and activities than traditional Webinars. However, there are significant limitations that must be overcome in order for this healthcare training modality to be utilized on a large scale. These limitations included a lack of microgestures and issues regarding the technology being used. In spite of the limitations, however, the potential use of virtual worlds for the training of healthcare providers exists and should be researched further. This article discusses the need and intended benefits of virtual world training as well as the results and conclusions of the pilot study.

  7. Approach to team skills training of nuclear power plant control room crews

    International Nuclear Information System (INIS)

    Davis, L.T.; Gaddy, C.D.; Turney, J.R.

    1985-07-01

    An investigation of current team skills training practices and research was conducted by General Physics Corporation for the Office of Nuclear Reactor Regulation. The methodology used included a review of relevant team skills training literature and a workshop to collect inputs from team training practitioners and researchers from the public and private sectors. The workshop was attended by representatives from nuclear utility training organizations, the commercial airline industry, federal agencies, and defense training and research commands. The literature reviews and workshop results provided the input for a suggested approach to team skills training that can be integrated into existing training programs for control room operating crews. The approach includes five phases: (1) team skills objectives development, (2) basic team skills training, (3) team task training, (4) team skills evaluation, and (5) team training program evaluation. Supporting background information and a user-oriented description of the approach to team skills training are provided. 47 refs

  8. 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.

  9. Simulation-based education: understanding the socio-cultural complexity of a surgical training 'boot camp'.

    Science.gov (United States)

    Cleland, Jennifer; Walker, Kenneth G; Gale, Michael; Nicol, Laura G

    2016-08-01

    The focus of simulation-based education (SBE) research has been limited to outcome and effectiveness studies. The effect of social and cultural influences on SBE is unclear and empirical work is lacking. Our objective in this study was to explore and understand the complexity of context and social factors at a surgical boot camp (BC). A rapid ethnographic study, employing the theoretical lenses of complexity and activity theory and Bourdieu's concept of 'capital', to better understand the socio-cultural influences acting upon, and during, two surgical BCs, and their implications for SBE. Over two 4-day BCs held in Scotland, UK, an observer and two preceptors conducted 81 hours of observations, 14 field interviews and 11 formal interviews with faculty members (n = 10, including the lead faculty member, session leaders and junior faculty members) and participants (n = 19 core surgical trainees and early-stage residents). Data collection and inductive analysis for emergent themes proceeded iteratively. This paper focuses on three analytical themes. First, the complexity of the surgical training system and wider health care education context, and how this influenced the development of the BC. Second, participants' views of the BC as a vehicle not just for learning skills but for gaining 'insider information' on how best to progress in surgical training. Finally, the explicit aim of faculty members to use the Scottish Surgical Bootcamp to welcome trainees and residents into the world of surgery, and how this occurred. To the best of our knowledge, this is the first empirical study of a surgical BC that takes a socio-cultural approach to exploring and understanding context, complexities, uncertainties and learning associated with one example of SBE. Our findings suggest that a BC is as much about social and cultural processes as it is about individual, cognitive and acquisitive learning. Acknowledging this explicitly will help those planning similar enterprises and

  10. An integrated approach to endoscopic instrument tracking for augmented reality applications in surgical simulation training.

    Science.gov (United States)

    Loukas, Constantinos; Lahanas, Vasileios; Georgiou, Evangelos

    2013-12-01

    Despite the popular use of virtual and physical reality simulators in laparoscopic training, the educational potential of augmented reality (AR) has not received much attention. A major challenge is the robust tracking and three-dimensional (3D) pose estimation of the endoscopic instrument, which are essential for achieving interaction with the virtual world and for realistic rendering when the virtual scene is occluded by the instrument. In this paper we propose a method that addresses these issues, based solely on visual information obtained from the endoscopic camera. Two different tracking algorithms are combined for estimating the 3D pose of the surgical instrument with respect to the camera. The first tracker creates an adaptive model of a colour strip attached to the distal part of the tool (close to the tip). The second algorithm tracks the endoscopic shaft, using a combined Hough-Kalman approach. The 3D pose is estimated with perspective geometry, using appropriate measurements extracted by the two trackers. The method has been validated on several complex image sequences for its tracking efficiency, pose estimation accuracy and applicability in AR-based training. Using a standard endoscopic camera, the absolute average error of the tip position was 2.5 mm for working distances commonly found in laparoscopic training. The average error of the instrument's angle with respect to the camera plane was approximately 2°. The results are also supplemented by video segments of laparoscopic training tasks performed in a physical and an AR environment. The experiments yielded promising results regarding the potential of applying AR technologies for laparoscopic skills training, based on a computer vision framework. The issue of occlusion handling was adequately addressed. The estimated trajectory of the instruments may also be used for surgical gesture interpretation and assessment. Copyright © 2013 John Wiley & Sons, Ltd.

  11. Role of simulator training in developing teamwork and diagnostic skills

    International Nuclear Information System (INIS)

    Grimme, W.E.

    1987-01-01

    A review of the evolution of the control room team is necessary to understand team training needs. As control room responsibilities have increased and members have been added to the operating crews, teamwork and strong leadership has become crucial to the efficiency of these operating crews. In order to conduct effective team training in a simulated control room, it is essential that the fundamental principles of role definition and common team values are fully developed. The diagnostics model used to develop problem-solving skills must be adaptable to the dynamic environment of the control room. Once the fundamental principles of team building and a good diagnostics model are mastered, many training techniques using a simulator are available to perfect the development of team building and diagnostic skills

  12. Systematic review and meta-analysis of the role of mental training in the acquisition of technical skills in surgery.

    Science.gov (United States)

    Rao, Ahsan; Tait, Ian; Alijani, Afshin

    2015-09-01

    Mental training is rehearsal of mental imagery without physically performing the task. The aim of the study was to perform systematic review and meta-analysis on all the available data to evaluate the role of mental training in the acquisition of surgical technical skills. The following search databases were used: EMBASE, MEDLINE, Web of Science, Clinicaltrials.gov.uk, SIGN guidelines, NICE guidelines, and Cochrane review register. Meta-analysis was performed using Revman 5.2 statistical software. There were a total of 9 randomized controlled trials with 474 participants, of which 189 participants received mental training. Five randomized controlled trials concluded positive impact of mental training. Mental training group did not show any significant improvement in overall performance of the task carried in each study (P = .06). Mental training can be used as an important supplementary tool in learning surgical skills when run in parallel with physical training and applied to trainees with some experience of the skill. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Perioperative feedback in surgical training: A systematic review.

    Science.gov (United States)

    McKendy, Katherine M; Watanabe, Yusuke; Lee, Lawrence; Bilgic, Elif; Enani, Ghada; Feldman, Liane S; Fried, Gerald M; Vassiliou, Melina C

    2017-07-01

    Changes in surgical training have raised concerns about residents' operative exposure and preparedness for independent practice. One way of addressing this concern is by optimizing teaching and feedback in the operating room (OR). The objective of this study was to perform a systematic review on perioperative teaching and feedback. A systematic literature search identified articles from 1994 to 2014 that addressed teaching, feedback, guidance, or debriefing in the perioperative period. Data was extracted according to ENTREQ guidelines, and a qualitative analysis was performed. Thematic analysis of the 26 included studies identified four major topics. Observation of teaching behaviors in the OR described current teaching practices. Identification of effective teaching strategies analyzed teaching behaviors, differentiating positive and negative teaching strategies. Perceptions of teaching behaviors described resident and attending satisfaction with teaching in the OR. Finally models for delivering structured feedback cited examples of feedback strategies and measured their effectiveness. This study provides an overview of perioperative teaching and feedback for surgical trainees and identifies a need for improved quality and quantity of structured feedback. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Effects of a Self-Instruction Communication Skills Training on Skills, Self-Efficacy, Motivation, and Transfer

    Science.gov (United States)

    Hommes, Mark A.; Van der Molen, Henk T.

    2012-01-01

    This article describes a study on the effects of a self-instruction training programme in communication skills for psychology students at the Open University of the Netherlands in comparison to a fully supervised training. We expected both training programmes to increase students' knowledge and skills, as well as their self-efficacy and motivation…

  15. Training surgical residents for a career in academic global surgery: a novel training model.

    Science.gov (United States)

    Swain, JaBaris D; Matousek, Alexi C; Scott, John W; Cooper, Zara; Smink, Douglas S; Bolman, Ralph Morton; Finlayson, Samuel R G; Zinner, Michael J; Riviello, Robert

    2015-01-01

    Academic global surgery is a nascent field focused on improving surgical care in resource-poor settings through a broad-based scholarship agenda. Although there is increasing momentum to expand training opportunities in low-resource settings among academic surgical programs, most focus solely on establishing short-term elective rotations rather than fostering research or career development. Given the complex nature of surgical care delivery and programmatic capacity building in the resource-poor settings, many challenges remain before global surgery is accepted as an academic discipline and an established career path. Brigham and Women's Hospital has established a specialized global surgery track within the general surgery residency program to develop academic leaders in this growing area of need and opportunity. Here we describe our experience with the design and development of the program followed by practical applications and lessons learned from our early experiences. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  16. Virtual reality simulators: valuable surgical skills trainers or video games?

    Science.gov (United States)

    Willis, Ross E; Gomez, Pedro Pablo; Ivatury, Srinivas J; Mitra, Hari S; Van Sickle, Kent R

    2014-01-01

    Virtual reality (VR) and physical model (PM) simulators differ in terms of whether the trainee is manipulating actual 3-dimensional objects (PM) or computer-generated 3-dimensional objects (VR). Much like video games (VG), VR simulators utilize computer-generated graphics. These differences may have profound effects on the utility of VR and PM training platforms. In this study, we aimed to determine whether a relationship exists between VR, PM, and VG platforms. VR and PM simulators for laparoscopic camera navigation ([LCN], experiment 1) and flexible endoscopy ([FE] experiment 2) were used in this study. In experiment 1, 20 laparoscopic novices played VG and performed 0° and 30° LCN exercises on VR and PM simulators. In experiment 2, 20 FE novices played VG and performed colonoscopy exercises on VR and PM simulators. In both experiments, VG performance was correlated with VR performance but not with PM performance. Performance on VR simulators did not correlate with performance on respective PM models. VR environments may be more like VG than previously thought. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

  17. Alternating skills training and clerkships to ease the transition from preclinical to clinical training

    NARCIS (Netherlands)

    Van Hell, E.A.; Kuks, J.B.; Borleffs, J.C.; Cohen-Schotanus, J.

    2011-01-01

    Background: The transition from preclinical to clinical training is perceived as stressful with a high workload being the main difficulty. To ease this transition, we implemented a dual learning year, where just-in-time skills training and clerkships alternated. Aims: To examine the effect of the

  18. Instructional skills training - the Westinghouse program to insure competence of nuclear training instructors

    International Nuclear Information System (INIS)

    Widen, W.C.

    1983-01-01

    The nuclear training engineer as well as being competent technically must be able to teach effectively. Westinghouse have developed a course for training instructors which aims to improve their teaching skills. The course, which has both theoretical and practical content covers the role of the instructor, the learning process, communications, test construction and analysis and stress identification and analysis. (U.K.)

  19. Training Self-Regulated Learning Skills with Video Modeling Examples: Do Task-Selection Skills Transfer?

    Science.gov (United States)

    Raaijmakers, Steven F.; Baars, Martine; Schaap, Lydia; Paas, Fred; van Merriënboer, Jeroen; van Gog, Tamara

    2018-01-01

    Self-assessment and task-selection skills are crucial in self-regulated learning situations in which students can choose their own tasks. Prior research suggested that training with video modeling examples, in which another person (the model) demonstrates and explains the cyclical process of problem-solving task performance, self-assessment, and…

  20. 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

  1. A reusable suture anchor for arthroscopy psychomotor skills training.

    Science.gov (United States)

    Tillett, Edward D; Rogers, Rainie; Nyland, John

    2003-03-01

    For residents to adequately develop the early arthroscopy psychomotor skills required to better learn how to manage the improvisational situations they will encounter during actual patient cases, they need to experience sufficient practice repetitions within a contextually relevant environment. Unfortunately, the cost of suture anchors can be a practice repetition-limiting factor in learning arthroscopic knot-tying techniques. We describe a technique for creating inexpensive reusable suture anchors and provide an example of their application to repair the anterior glenoid labrum during an arthroscopy psychomotor skills laboratory training session.

  2. Communication skills training curriculum for pulmonary and critical care fellows.

    Science.gov (United States)

    McCallister, Jennifer W; Gustin, Jillian L; Wells-Di Gregorio, Sharla; Way, David P; Mastronarde, John G

    2015-04-01

    The Accreditation Council for Graduate Medical Education requires physicians training in pulmonary and critical care medicine to demonstrate competency in interpersonal communication. Studies have shown that residency training is often insufficient to prepare physicians to provide end-of-life care and facilitate patient and family decision-making. Poor communication in the intensive care unit (ICU) can adversely affect outcomes for critically ill patients and their family members. Despite this, communication training curricula in pulmonary and critical care medicine are largely absent in the published literature. We evaluated the effectiveness of a communication skills curriculum during the first year of a pulmonary and critical care medicine fellowship using a family meeting checklist to provide formative feedback to fellows during ICU rotations. We hypothesized that fellows would demonstrate increased competence and confidence in the behavioral skills necessary for facilitating family meetings. We evaluated a 12-month communication skills curriculum using a pre-post, quasiexperimental design. Subjects for this study included 11 first-year fellows who participated in the new curriculum (intervention group) and a historical control group of five fellows who had completed no formal communication curriculum. Performance of communication skills and self-confidence in family meetings were assessed for the intervention group before and after the curriculum. The control group was assessed once at the beginning of their second year of fellowship. Fellows in the intervention group demonstrated significantly improved communication skills as evaluated by two psychologists using the Family Meeting Behavioral Skills Checklist, with an increase in total observed skills from 51 to 65% (P ≤ 0.01; Cohen's D effect size [es], 1.13). Their performance was also rated significantly higher when compared with the historical control group, who demonstrated only 49% of observed skills

  3. 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.

  4. High acceptability of a newly developed urological practical skills training program.

    NARCIS (Netherlands)

    Vries, A.H. de; Luijk, S.J. van; Scherpbier, A.J.J.A.; Hendrikx, A.J.M.; Koldewijn, E.L.; Wagner, C.; Schout, B.M.A.

    2015-01-01

    Background: Benefits of simulation training are widely recognized, but its structural implementation into urological curricula remains challenging. This study aims to gain insight into current and ideal urological practical skills training and presents the outline of a newly developed skills

  5. High acceptability of a newly developed urological practical skills training program

    NARCIS (Netherlands)

    de Vries, A.H.; van Luijk, S.J.; Scherpbier, A.J.J.A.; Hendrikx, A.J.M.; Koldewijn, E.L.; Wagner, C.; Schout, B.M.A.

    2015-01-01

    Background: Benefits of simulation training are widely recognized, but its structural implementation into urological curricula remains challenging. This study aims to gain insight into current and ideal urological practical skills training and presents the outline of a newly developed skills

  6. 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.

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

    Science.gov (United States)

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

    2015-09-09

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

  8. Video games as a tool to train visual skills.

    Science.gov (United States)

    Achtman, R L; Green, C S; Bavelier, D

    2008-01-01

    Adult brain plasticity, although possible, is often difficult to elicit. Training regimens in adults can produce specific improvements on the trained task without leading to general enhancements that would improve quality of life. This paper considers the case of playing action video games as a way to induce widespread enhancement in vision. We review the range of visual skills altered by action video game playing as well as the game components important in promoting visual plasticity. Further, we discuss what these results might mean in terms of rehabilitation for different patient populations.

  9. Video games as a tool to train visual skills

    Science.gov (United States)

    Achtman, R.L.; Green, C.S.; Bavelier, D.

    2010-01-01

    Purpose Adult brain plasticity, although possible, is often difficult to elicit. Training regimens in adults can produce specific improvements on the trained task without leading to general enhancements that would improve quality of life. This paper considers the case of playing action video games as a way to induce widespread enhancement in vision. Conclusions We review the range of visual skills altered by action video game playing as well as the game components important in promoting visual plasticity. Further, we discuss what these results might mean in terms of rehabilitation for different patient populations. PMID:18997318

  10. Designing Serious Games for getting transferable skills in training settings

    Directory of Open Access Journals (Sweden)

    Félix Buendía-García

    2014-02-01

    Full Text Available Nowadays, serious games are present in almost every educational context. The current work deals with the design of serious games oriented towards getting transferable skills in different kinds of training settings. These games can be a valuable way of engaging citizens and workers in the learning process by means of metaphors or similar mechanisms close to their user experience. They also contain an encouragement factor to uptake generic job competencies. An approach is proposed to develop this type of game by mixing traditional design steps with an instructional strategy to provide structured learning bites in training settings. Several game prototypes have been developed to test this approach in the context of courses for public employees. The obtained outcomes reveal the wider possibilities of serious games as educational resources, as well as the use of game achievements to evaluate the acquisition of transferable skills.

  11. Dialectical Behavior Therapy Group Skills Training for Bipolar Disorder.

    Science.gov (United States)

    Eisner, Lori; Eddie, David; Harley, Rebecca; Jacobo, Michelle; Nierenberg, Andrew A; Deckersbach, Thilo

    2017-07-01

    There is growing evidence that the capacity for emotion regulation is compromised in individuals with bipolar disorder. Dialectical behavior therapy (DBT), an empirically supported treatment that specifically targets emotion dysregulation, may be an effective adjunct treatment for improving emotion regulation and residual mood symptoms in patients with bipolar disorder. In this open, proof-of-concept pilot study, 37 participants engaged in a 12-week DBT group skills training program, learning mindfulness, emotion regulation, and distress tolerance skills. Repeated measures mixed models revealed skill acquisition in the areas of mindfulness, emotion regulation and distress tolerance, as well as improved psychological well-being and decreased emotion reactivity. The results of this study support a burgeoning literature that DBT is a feasible adjunct intervention for patients with bipolar disorder. Copyright © 2017. Published by Elsevier Ltd.

  12. Gaze training enhances laparoscopic technical skill acquisition and multi-tasking performance: a randomized, controlled study.

    Science.gov (United States)

    Wilson, Mark R; Vine, Samuel J; Bright, Elizabeth; Masters, Rich S W; Defriend, David; McGrath, John S

    2011-12-01

    The operating room environment is replete with stressors and distractions that increase the attention demands of what are already complex psychomotor procedures. Contemporary research in other fields (e.g., sport) has revealed that gaze training interventions may support the development of robust movement skills. This current study was designed to examine the utility of gaze training for technical laparoscopic skills and to test performance under multitasking conditions. Thirty medical trainees with no laparoscopic experience were divided randomly into one of three treatment groups: gaze trained (GAZE), movement trained (MOVE), and discovery learning/control (DISCOVERY). Participants were fitted with a Mobile Eye gaze registration system, which measures eye-line of gaze at 25 Hz. Training consisted of ten repetitions of the "eye-hand coordination" task from the LAP Mentor VR laparoscopic surgical simulator while receiving instruction and video feedback (specific to each treatment condition). After training, all participants completed a control test (designed to assess learning) and a multitasking transfer test, in which they completed the procedure while performing a concurrent tone counting task. Not only did the GAZE group learn more quickly than the MOVE and DISCOVERY groups (faster completion times in the control test), but the performance difference was even more pronounced when multitasking. Differences in gaze control (target locking fixations), rather than tool movement measures (tool path length), underpinned this performance advantage for GAZE training. These results suggest that although the GAZE intervention focused on training gaze behavior only, there were indirect benefits for movement behaviors and performance efficiency. Additionally, focusing on a single external target when learning, rather than on complex movement patterns, may have freed-up attentional resources that could be applied to concurrent cognitive tasks.

  13. Effectiveness and safety of wheelchair skills training program in improving the wheelchair skills capacity: a systematic review.

    Science.gov (United States)

    Tu, Chun-Jing; Liu, Lin; Wang, Wei; Du, He-Ping; Wang, Yu-Ming; Xu, Yan-Bing; Li, Ping

    2017-12-01

    To comprehensively assess the effectiveness and safety of wheelchair skills training program in improving wheelchair skills capacity. PubMed, OVID, EBSCO, ScienceDirect, Web of Science, CINAHL, Cochrane Library, Google Scholar, and China Knowledge Resource Integrated Database were searched up to March 2017. Controlled clinical trials that compared a wheelchair skills training program with a control group that received other interventions and used the wheelchair skills test scores to evaluate wheelchair skills capacity were included. Two authors independently screened articles, extracted data, and assessed the methodological quality using the Cochrane risk-of-bias tool in randomized controlled trial (RCT) and methodological index for non-randomized studies. The data results of wheelchair skills test scores were extracted. Data from 455 individuals in 10 RCTs and from 140 participants in seven non-randomized studies were included for meta-analysis using Stata version 12.0 (Stata Corporation, College Station, TX, USA). In the short term (immediately to one week) post-intervention, relative to a control group, manual wheelchair skills training could increase the total wheelchair skills test scores by 13.26% in RCTs (95% confidence interval (CI), 6.19%-20.34%; P skills training and the long-term (3-12 months) advantage of manual wheelchair skills training ( P = 0.755). The limited evidence suggests that wheelchair skills training program is beneficial in the short term, but its long-term effects remain unclear.

  14. Training self-assessment and task-selection skills to foster self-regulated learning: Do trained skills transfer across domains?

    Science.gov (United States)

    Raaijmakers, Steven F; Baars, Martine; Paas, Fred; van Merriënboer, Jeroen J G; van Gog, Tamara

    2018-01-01

    Students' ability to accurately self-assess their performance and select a suitable subsequent learning task in response is imperative for effective self-regulated learning. Video modeling examples have proven effective for training self-assessment and task-selection skills, and-importantly-such training fostered self-regulated learning outcomes. It is unclear, however, whether trained skills would transfer across domains. We investigated whether skills acquired from training with either a specific, algorithmic task-selection rule or a more general heuristic task-selection rule in biology would transfer to self-regulated learning in math. A manipulation check performed after the training confirmed that both algorithmic and heuristic training improved task-selection skills on the biology problems compared with the control condition. However, we found no evidence that students subsequently applied the acquired skills during self-regulated learning in math. Future research should investigate how to support transfer of task-selection skills across domains.

  15. Integration and Validation of Hysteroscopy Simulation in the Surgical Training Curriculum.

    Science.gov (United States)

    Elessawy, Mohamed; Skrzipczyk, Moritz; Eckmann-Scholz, Christel; Maass, Nicolai; Mettler, Liselotte; Guenther, Veronika; van Mackelenbergh, Marion; Bauerschlag, Dirk O; Alkatout, Ibrahim

    The primary objective of our study was to test the construct validity of the HystSim hysteroscopic simulator to determine whether simulation training can improve the acquisition of hysteroscopic skills regardless of the previous levels of experience of the participants. The secondary objective was to analyze the performance of a selected task, using specially designed scoring charts to help reduce the learning curve for both novices and experienced surgeons. The teaching of hysteroscopic intervention has received only scant attention, focusing mainly on the development of physical models and box simulators. This encouraged our working group to search for a suitable hysteroscopic simulator module and to test its validation. We decided to use the HystSim hysteroscopic simulator, which is one of the few such simulators that has already completed a validation process, with high ratings for both realism and training capacity. As a testing tool for our study, we selected the myoma resection task. We analyzed the results using the multimetric score system suggested by HystSim, allowing a more precise interpretation of the results. Between June 2014 and May 2015, our group collected data on 57 participants of minimally invasive surgical training courses at the Kiel School of Gynecological Endoscopy, Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel. The novice group consisted of 42 medical students and residents with no prior experience in hysteroscopy, whereas the expert group consisted of 15 participants with more than 2 years of experience of advanced hysteroscopy operations. The overall results demonstrated that all participants attained significant improvements between their pretest and posttests, independent of their previous levels of experience (p hysteroscopic skills, proving an adequate construct validation of the HystSim. Using the multimetric scoring system enabled a more accurate analysis of the performance of the

  16. Developing apprentice skills for innovation through interdisciplinary training and education

    DEFF Research Database (Denmark)

    Haslam, Christian Ravn

    2016-01-01

    This paper is concerned with training students of vocational education programs; specifically, tradesmen and skilled workers to better utilise value networks and knowledge hubs, set up through government initiatives, as an innovation platform. The study indicates that massively interdisciplinary...... not only interdisciplinary collaboration but also entrepreneurship in general. The study is based on two years of experimentation running six independent workshops across ten different disciplines and trades and four educational institutions....

  17. Cognitive and Technical Skill Assessment in Surgical Education: a Changing Horizon.

    Science.gov (United States)

    Vergis, Ashley; Hardy, Krista

    2017-04-01

    Assessment is an integral component of training and credentialing surgeons for practice. Traditional methods of cognitive and technical appraisal are well established but have clear shortcomings. This review outlines the components of the surgical care assessment model, identifies the deficits of current evaluation techniques, and discusses novel and emerging technologies that attempt to ameliorate this educational void.

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

    LENUS (Irish Health Repository)

    Carroll, Sean M

    2012-02-01

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

  19. A Meta-Analysis of Skills Training Programs for Rehabilitation Clients.

    Science.gov (United States)

    Bolton, Brian; Akridge, Robert L.

    1995-01-01

    Summarized the results of 15 experimental studies of 10 small-group skills training interventions developed for use with vocational rehabilitation clients. Concluded that the typical participant in skills training interventions received substantial benefit from the activity. Skills training programs should be implemented more widely with clients…

  20. 76 FR 62455 - Announcement of Updated Funding Availability for H-1B Technical Skills Training Grants

    Science.gov (United States)

    2011-10-07

    ... 10-13] Announcement of Updated Funding Availability for H-1B Technical Skills Training Grants AGENCY... the availability of $240 million for the H-1B Technical Skills Training Grants to be awarded through a... additional applicants to apply for the H-1B Technical Skills Training Grants competition that will close on...