WorldWideScience

Sample records for surgical training programs

  1. Supply versus demand: a review of application trends to Canadian surgical training programs.

    Science.gov (United States)

    Austin, Ryan E; Wanzel, Kyle R

    2015-04-01

    Despite increases in medical school enrolment, applications to surgical residency programs in Canada have been in decline over the past decade, with an increasing number of unmatched surgical residency positions. We examined the current status of surgical residency in Canada and analyzed application trends (2002–2013) for surgical training programs across Canada. Our findings suggest that most undergraduate medical schools across Canada are having difficulty fostering interest in surgical careers. We propose that a lack of adequate early exposure to the surgical specialties during undergraduate training is a critical factor. Moving forward, we must examine how the best-performing institutions and surgical programs have maintained interest in pursuing surgical careers and adapt our recruitment methods to both maintain and grow future interest. As Mary Engelbreit said, "If you don't like something, change it; if you can't change it, change the way you think about it."

  2. Effect of Process Changes in Surgical Training on Quantitative Outcomes From Surgery Residency Programs.

    Science.gov (United States)

    Dietl, Charles A; Russell, John C

    2016-01-01

    The purpose of this article is to review the literature on process changes in surgical training programs and to evaluate their effect on the Accreditation Council of Graduate Medical Education (ACGME) Core Competencies, American Board of Surgery In-Training Examination (ABSITE) scores, and American Board of Surgery (ABS) certification. A literature search was obtained from MEDLINE via PubMed.gov, ScienceDirect.com, Google Scholar on all peer-reviewed studies published since 2003 using the following search queries: surgery residency training, surgical education, competency-based surgical education, ACGME core competencies, ABSITE scores, and ABS pass rate. Our initial search list included 990 articles on surgery residency training models, 539 on competency-based surgical education, 78 on ABSITE scores, and 33 on ABS pass rate. Overall, 31 articles met inclusion criteria based on their effect on ACGME Core Competencies, ABSITE scores, and ABS certification. Systematic review showed that 5/31, 19/31, and 6/31 articles on process changes in surgical training programs had a positive effect on patient care, medical knowledge, and ABSITE scores, respectively. ABS certification was not analyzed. The other ACGME core competencies were addressed in only 6 studies. Several publications on process changes in surgical training programs have shown a positive effect on patient care, medical knowledge, and ABSITE scores. However, the effect on ABS certification, and other quantitative outcomes from residency programs, have not been addressed. Studies on education strategies showing evidence that residency program objectives are being achieved are still needed. This article addresses the 6 ACGME Core Competencies. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  3. Teaching methods and surgical training in North American graduate periodontics programs: exploring the landscape.

    Science.gov (United States)

    Ghiabi, Edmond; Taylor, K Lynn

    2010-06-01

    This project aimed at documenting the surgical training curricula offered by North American graduate periodontics programs. A survey consisting of questions on teaching methods employed and the content of the surgical training program was mailed to directors of all fifty-eight graduate periodontics programs in Canada and the United States. The chi-square test was used to assess whether the residents' clinical experience was significantly (Pperiodontal plastic procedures, hard tissue grafts, and implants. Furthermore, residents in programs offering a structured preclinical component performed significantly more procedures (P=0.012) using lasers than those in programs not offering a structured preclinical program. Devising new and innovative teaching methods is a clear avenue for future development in North American graduate periodontics programs.

  4. A Communication Training Program to Encourage Speaking-Up Behavior in Surgical Oncology.

    Science.gov (United States)

    D'Agostino, Thomas A; Bialer, Philip A; Walters, Chasity B; Killen, Aileen R; Sigurdsson, Hrafn O; Parker, Patricia A

    2017-10-01

    Patient safety in the OR depends on effective communication. We developed and tested a communication training program for surgical oncology staff members to increase communication about patient safety concerns. In phase one, 34 staff members participated in focus groups to identify and rank factors that affect speaking-up behavior. We compiled ranked items into thematic categories that included role relations and hierarchy, staff rapport, perceived competence, perceived efficacy of speaking up, staff personality, fear of retaliation, institutional regulations, and time pressure. We then developed a communication training program that 42 participants completed during phase two. Participants offered favorable ratings of the usefulness and perceived effect of the training. Participants reported significant improvement in communicating patient safety concerns (t 40  = -2.76, P = .009, d = 0.48). Findings offer insight into communication challenges experienced by surgical oncology staff members and suggest that our training demonstrates the potential to improve team communication. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  5. 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.

  6. Basic surgical training in Ireland: the impact of operative experience, training program allocation and mentorship on trainee satisfaction.

    LENUS (Irish Health Repository)

    O'Sullivan, K E

    2013-12-01

    Application to the Irish basic surgical training (BST) program in Ireland has decreased progressively over the past 5 years. We hypothesised that this decline was secondary to dissatisfaction with training correlated with reduced operative experience and lack of mentorship among BSTs.

  7. 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.

  8. 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.

  9. ACGME core competency training, mentorship, and research in surgical subspecialty fellowship programs.

    Science.gov (United States)

    Francesca Monn, M; Wang, Ming-Hsien; Gilson, Marta M; Chen, Belinda; Kern, David; Gearhart, Susan L

    2013-01-01

    To determine the perceived effectiveness of surgical subspecialty training programs in teaching and assessing the 6 ACGME core competencies including research. Cross-sectional survey. ACGME approved training programs in pediatric urology and colorectal surgery. Program Directors and recent trainees (2007-2009). A total of 39 program directors (60%) and 57 trainees (64%) responded. Both program directors and recent trainees reported a higher degree of training and mentorship (75%) in patient care and medical knowledge than the other core competencies (pinterpersonal and communication, and professionalism training were perceived effective to a lesser degree. Specifically, in the areas of teaching residents and medical students and team building, program directors, compared with recent trainees, perceived training to be more effective, (p = 0.004, p = 0.04). Responses to questions assessing training in systems based practice ubiquitously identified a lack of training, particularly in financial matters of running a practice. Although effective training in research was perceived as lacking by recent trainees, 81% reported mentorship in this area. According to program directors and recent trainees, the most effective method of teaching was faculty supervision and feedback. Only 50% or less of the recent trainees reported mentorship in career planning, work-life balance, and job satisfaction. Not all 6 core competencies and research are effectively being taught in surgery subspecialty training programs and mentorship in areas outside of patient care and research is lacking. Emphasis should be placed on faculty supervision and feedback when designing methods to better incorporate all 6 core competencies, research, and mentorship. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  10. [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.

  11. 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.

  12. Effects of a training program after surgically treated ankle fracture: a prospective randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Ekdahl Charlotte S

    2009-09-01

    Full Text Available Abstract Background Despite conflicting results after surgically treated ankle fractures few studies have evaluated the effects of different types of training programs performed after plaster removal. The aim of this study was to evaluate the effects of a 12-week standardised but individually suited training program (training group versus usual care (control group after plaster removal in adults with surgically treated ankle fractures. Methods In total, 110 men and women, 18-64 years of age, with surgically treated ankle fracture were included and randomised to either a 12-week training program or to a control group. Six and twelve months after the injury the subjects were examined by the same physiotherapist who was blinded to the treatment group. The main outcome measure was the Olerud-Molander Ankle Score (OMAS which rates symptoms and subjectively scored function. Secondary outcome measures were: quality of life (SF-36, timed walking tests, ankle mobility tests, muscle strength tests and radiological status. Results 52 patients were randomised to the training group and 58 to the control group. Five patients dropped out before the six-month follow-up resulting in 50 patients in the training group and 55 in the control group. Nine patients dropped out between the six- and twelve-month follow-up resulting in 48 patients in both groups. When analysing the results in a mixed model analysis on repeated measures including interaction between age-group and treatment effect the training group demonstrated significantly improved results compared to the control group in subjects younger than 40 years of age regarding OMAS (p = 0.028, muscle strength in the plantar flexors (p = 0.029 and dorsiflexors (p = 0.030. Conclusion The results of this study suggest that when adjusting for interaction between age-group and treatment effect the training model employed in this study was superior to usual care in patients under the age of 40. However, as only three

  13. 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

  14. 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.

  15. 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

  16. 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

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

    Science.gov (United States)

    Ajao, Oluwole Gbolagunte; Alao, Adekola

    2016-01-01

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

  18. 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.

  19. Application of the "see one, do one, teach one" concept in surgical training.

    Science.gov (United States)

    Kotsis, Sandra V; Chung, Kevin C

    2013-05-01

    The traditional method of teaching in surgery is known as "see one, do one, teach one." However, many have argued that this method is no longer applicable, mainly because of concerns for patient safety. The purpose of this article is to show that the basis of the traditional teaching method is still valid in surgical training if it is combined with various adult learning principles. The authors reviewed literature regarding the history of the formation of the surgical residency program, adult learning principles, mentoring, and medical simulation. The authors provide examples for how these learning techniques can be incorporated into a surgical resident training program. The surgical residency program created by Dr. William Halsted remained virtually unchanged until recently with reductions in resident work hours and changes to a competency-based training system. Such changes have reduced the teaching time between attending physicians and residents. Learning principles such as experience, observation, thinking, and action and deliberate practice can be used to train residents. Mentoring is also an important aspect in teaching surgical technique. The authors review the different types of simulators-standardized patients, virtual reality applications, and high-fidelity mannequin simulators-and the advantages and disadvantages of using them. The traditional teaching method of "see one, do one, teach one" in surgical residency programs is simple but still applicable. It needs to evolve with current changes in the medical system to adequately train surgical residents and also provide patients with safe, evidence-based care.

  20. 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.

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

    DEFF Research Database (Denmark)

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

    Purpose: The purpose of this study was to test the construct validity of a full virtual reality vitreoretinal training program at the Eyesi Surgical simulator. Design and methods: A virtual vitreoretinal training program was composed on the Eyesi Surgical simulator, software version 2.9.2 (VRmagic...... GmbH, Manheim, Germany). It was completed twice by three groups: Group 1: Twenty medical students Group 2: Ten ophthalmology residents Group 3: Five vitreoretinal surgeons The program consisted of six training modules (Figure 1): Navigation level 2 (Nav2) Forceps Training level 5 (ForT5) Bimanual...... developed a training program in virtual vitreoretinal surgery with construct validity for four out of six modules and for overall score. This makes the program a useful tool in the training of future vitreoretinal surgeons....

  2. 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

  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. 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

  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. 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.

  7. 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

  8. 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

  9. Medical Officers in Sierra Leone: Surgical Training Opportunities, Challenges and Aspirations.

    Science.gov (United States)

    Wilks, Lucy; Leather, Andrew; George, Peter Matthew; Kamara, Thaim Bay

    2018-02-05

    The critical shortage of human resources for healthcare falls most heavily on sub-Saharan nations such as Sierra Leone, where such workforce deficits have grave impacts on its burden of surgical disease. An important aspect in retention and development of the workforce is training. This study focuses on postgraduate surgical training (formal and short course) and perceptions of opportunities, challenges and aspirations, in a country where more than half of surgical procedures are performed by medical officers. The study presents findings from 12 in-depth semi-structured interviews conducted with medical officers by the primary investigator in Sierra Leone between April and June 2017. Each interview was transcribed alongside an introspective reflexive journal to acknowledge and account for researcher biases. Two interviewees had accessed postgraduate surgical training and 10 (83%) had accessed short course surgically relevant training. The number of short courses accessed grew higher the more recently the medical officers had graduated. Supervision, short length and international standards were the most appreciated aspects of short training courses. Some medical officers perceived the formal postgraduate surgical training programme to be ill-equipped, doubting its credibility. This demotivated some from applying. Training is an essential aspect of developing an adequate surgical workforce. Faith must be restored in the capabilities of Sierra Leone's Ministry of Health and Sanitation to provide adequate and sustainable training. This study advocates for the use of short courses to restore this faith and the expansion of postgraduate surgical training to the districts through developing a regional teaching complex to provide short courses and eventually formal postgraduate training in the future. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  10. [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.

  11. The role of inter-institutional cooperation in surgical training and ...

    African Journals Online (AJOL)

    Methods: Contact was first initiated between the heads of department at the two institutions and communications was almost entirely through e-mail. A Memorandum of Understanding ... taking part in the exchange programs. Keywords: Surgical training, North-South divide, academic exchange programs, Tanzania, Germany ...

  12. 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

  13. General surgery residents' perception of robot-assisted procedures during surgical training.

    Science.gov (United States)

    Farivar, Behzad S; Flannagan, Molly; Leitman, I Michael

    2015-01-01

    With the continued expansion of robotically assisted procedures, general surgery residents continue to receive more exposure to this new technology as part of their training. There are currently no guidelines or standardized training requirements for robot-assisted procedures during general surgical residency. The aim of this study was to assess the effect of this new technology on general surgery training from the residents' perspective. An anonymous, national, web-based survey was conducted on residents enrolled in general surgery training in 2013. The survey was sent to 240 Accreditation Council for Graduate Medical Education-approved general surgery training programs. Overall, 64% of the responding residents were men and had an average age of 29 years. Half of the responses were from postgraduate year 1 (PGY1) and PGY2 residents, and the remainder was from the PGY3 level and above. Overall, 50% of the responses were from university training programs, 32% from university-affiliated programs, and 18% from community-based programs. More than 96% of residents noted the availability of the surgical robot system at their training institution. Overall, 63% of residents indicated that they had participated in robotic surgical cases. Most responded that they had assisted in 10 or fewer robotic cases with the most frequent activities being assisting with robotic trocar placement and docking and undocking the robot. Only 18% reported experience with operating the robotic console. More senior residents (PGY3 and above) were involved in robotic cases compared with junior residents (78% vs 48%, p robotic case. Approximately 64% of residents reported that formal training in robotic surgery was important in residency training and 46% of residents indicated that robotic-assisted cases interfered with resident learning. Only 11% felt that robotic-assisted cases would replace conventional laparoscopic surgery in the future. This study illustrates that although the most residents

  14. 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.

  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. 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....

  17. [Resident evaluation of general surgery training programs].

    Science.gov (United States)

    Espinoza G, Ricardo; Danilla E, Stefan; Valdés G, Fabio; San Francisco R, Ignacio; Llanos L, Osvaldo

    2009-07-01

    The profile of the general surgeon has changed, aiming to incorporate new skills and to develop new specialties. To assess the quality of postgraduate General Surgery training programs given by Chilean universities, the satisfaction of students and their preferences after finishing the training period. A survey with multiple choice and Likert type questions was designed and applied to 77 surgery residents, corresponding to 59% of all residents of general surgery specialization programs of Chilean universities. Fifty five per cent of residents financed with their own resources the specialization program. Thirty nine percent disagreed partially or totally with the objectives and rotations of programs. The opportunity to perform surgical interventions and the support by teachers was well evaluated. However, 23% revealed teacher maltreatment. Fifty six percent performed research activities, 73% expected to continue training in a derived specialty and 69% was satisfied with the training program. Residents considered that the quality and dedication of professors and financing of programs are issues that must be improved. The opportunity to perform surgical interventions, obtaining a salary for their work and teacher support is considered of utmost importance.

  18. 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.

  19. Are surgery training programs ready for virtual reality? A survey of program directors in general surgery.

    Science.gov (United States)

    Haluck, R S; Marshall, R L; Krummel, T M; Melkonian, M G

    2001-12-01

    The use of advanced technology, such as virtual environments and computer-based simulators (VR/CBS), in training has been well established by both industry and the military. In contrast the medical profession, including surgery, has been slow to incorporate such technology in its training. In an attempt to identify factors limiting the regular incorporation of this technology into surgical training programs, a survey was developed and distributed to all general surgery program directors in the United States. A 22-question survey was sent to 254 general surgery program directors. The survey was designed to reflect attitudes of the program directors regarding the use of computer-based simulation in surgical training. Questions were scaled from 1 to 5 with 1 = strongly disagree and 5 = strongly agree. A total of 139 responses (55%) were returned. The majority of respondents (58%) had seen VR/CBS, but only 19% had "hands-on" experience with these systems. Respondents strongly agreed that there is a need for learning opportunities outside of the operating room and a role for VR/CBS in surgical training. Respondents believed both staff and residents would support this type of training. Concerns included VR/CBS' lack of validation and potential requirements for frequent system upgrades. Virtual environments and computer-based simulators, although well established training tools in other fields, have not been widely incorporated into surgical education. Our results suggest that program directors believe this type of technology would be beneficial in surgical education, but they lack adequate information regarding VR/CBS. Developers of this technology may need to focus on educating potential users and addressing their concerns.

  20. Effects of Technological Advances in Surgical Education on Quantitative Outcomes From Residency Programs.

    Science.gov (United States)

    Dietl, Charles A; Russell, John C

    2016-01-01

    The purpose of this article is to review the literature on current technology for surgical education and to evaluate the effect of technological advances on the Accreditation Council of Graduate Medical Education (ACGME) Core Competencies, American Board of Surgery In-Training Examination (ABSITE) scores, and American Board of Surgery (ABS) certification. A literature search was obtained from MEDLINE via PubMed.gov, ScienceDirect.com, and Google Scholar on all peer-reviewed studies published since 2003 using the following search queries: technology for surgical education, simulation-based surgical training, simulation-based nontechnical skills (NTS) training, ACGME Core Competencies, ABSITE scores, and ABS pass rate. Our initial search list included the following: 648 on technology for surgical education, 413 on simulation-based surgical training, 51 on simulation-based NTS training, 78 on ABSITE scores, and 33 on ABS pass rate. Further, 42 articles on technological advances for surgical education met inclusion criteria based on their effect on ACGME Core Competencies, ABSITE scores, and ABS certification. Systematic review showed that 33 of 42 and 26 of 42 publications on technological advances for surgical education showed objective improvements regarding patient care and medical knowledge, respectively, whereas only 2 of 42 publications showed improved ABSITE scores, but none showed improved ABS pass rates. Improvements in the other ACGME core competencies were documented in 14 studies, 9 of which were on simulation-based NTS training. Most of the studies on technological advances for surgical education have shown a positive effect on patient care and medical knowledge. However, the effect of simulation-based surgical training and simulation-based NTS training on ABSITE scores and ABS certification has not been assessed. Studies on technological advances in surgical education and simulation-based NTS training showing quantitative evidence that surgery residency

  1. Putting the MeaT into TeaM Training: Development, Delivery, and Evaluation of a Surgical Team-Training Workshop.

    Science.gov (United States)

    Seymour, Neal E; Paige, John T; Arora, Sonal; Fernandez, Gladys L; Aggarwal, Rajesh; Tsuda, Shawn T; Powers, Kinga A; Langlois, Gerard; Stefanidis, Dimitrios

    2016-01-01

    Despite importance to patient care, team training is infrequently used in surgical education. To address this, a workshop was developed by the Association for Surgical Education Simulation Committee to teach team training using high-fidelity patient simulators and the American College of Surgeons-Association of Program Directors in Surgery team-training curriculum. Workshops were conducted at 3 national meetings. Participants completed preworkshop and postworkshop questionnaires to define experience, confidence in using simulation, intention to implement, as well as workshop content quality. The course consisted of (A) a didactic review of Preparation, Implementation, and Debriefing and (B) facilitated small group simulation sessions followed by debriefings. Of 78 participants, 51 completed the workshops. Overall, 65% indicated that residents at their institutions used patient simulation, but only 33% used the American College of Surgeons-the Association of Program Directors in Surgery team-training modules. The workshop increased confidence to implement simulation team training (3.4 ± 1.3 vs 4.5 ± 0.9). Quality and importance were rated highly (5.4 ± 00.6, highest score = 6). Preparation for simulation-based team training is possible in this workshop setting, although the effect on actual implementation remains to be determined. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  2. 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.

  3. 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.

  4. Hands-On Surgical Training Workshop: an Active Role-Playing Patient Education for Adolescents.

    Science.gov (United States)

    Wongkietkachorn, Apinut; Boonyawong, Pangpoom; Rhunsiri, Peera; Tantiphlachiva, Kasaya

    2017-09-01

    Most patient education involves passive learning. To improve patient education regarding surgery, an active learning workshop-based teaching method is proposed. The objective of this study was to assess level of patient surgical knowledge, achievement of workshop learning objectives, patient apprehension about future surgery, and participant workshop satisfaction after completing a surgical training workshop. A four-station workshop (surgical scrub, surgical suture, laparoscopic surgery, and robotic surgery) was developed to teach four important components of the surgical process. Healthy, surgery-naive adolescents were enrolled to attend this 1-h workshop-based training program. Training received by participants was technically and procedurally identical to training received by actual surgeons. Pre- and post-workshop questionnaires were used to assess learning outcomes. There were 1312 participants, with a mean age 15.9 ± 1.1 years and a gender breakdown of 303 males and 1009 females. For surgical knowledge, mean pre-workshop and post-workshop scores were 6.1 ± 1.5 and 7.5 ± 1.5 (out of 10 points), respectively (p education is an effective way to improve understanding of surgery-related processes. This teaching method may also decrease apprehension that patients or potential patients harbor regarding a future surgical procedure.

  5. A Comparative Study of Surgical Training in South East Asia, Australia and The United Kingdom

    Directory of Open Access Journals (Sweden)

    Siew Kheong Lum

    2009-07-01

    Conclusion: Quality of training can be improved by changing to a curriculum and competency based model, utilization of continuous assessment methods, reducing service requirements and better compensation for trainers. Southeast Asia has the potential to provide centres of excellence for surgical training. Surgical educators in SEA will find useful information in this paper to improve their programs which will hopefully evolve into a common core curriculum and enable cross border exchange of surgical trainees in SEA for broader exposure.

  6. 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

  7. 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.

  8. 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

    The aim of this study was to understand the current situation of surgical education and training in Europe among members of the European Society of Gynecological Oncology (ESGO) and its impact on the daily surgical practice of those that have completed an accredited fellowship in gynecologic oncology. A questionnaire addressing topics of interest in surgical training was designed and sent to ESGO members with surgical experience in gynecologic oncology. The survey was completely confidentially and could be completed in less than 5 minutes. Responses from 349 members from 42 European countries were obtained, which was 38% of the potential target population. The respondents were divided into 2 groups depending on whether they had undergone an official accreditation process. Two thirds of respondents said they had received a good surgical education. However, accredited gynecologists felt that global surgical training was significantly better. Surgical self-confidence among accredited specialists was significantly higher regarding most surgical oncological procedures than it was among their peers without such accreditation. However, the rate of self-assurance in ultraradical operations, and bowel and urinary reconstruction was quite low in both groups. There was a general request for standardizing surgical education across the ESGO area. Respondents demanded further training in laparoscopy, ultraradical procedures, bowel and urinary reconstruction, and postoperative management of complications. Furthermore, they requested the creation of fellowship programs in places where they are not now accredited and the promotion of rotations and exchange in centers of excellence. Finally, respondents want supporting training in disadvantaged countries of the ESGO area. Specialists in gynecologic oncology that have obtained a formal accreditation received a significantly better surgical education than those that have not. The ESGO responders recognize that their society should

  9. 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.

  10. 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.

  11. 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

  12. A Review of Empathy, Its Importance, and Its Teaching in Surgical Training.

    Science.gov (United States)

    Han, Jing L; Pappas, Theodore N

    There has been much discussion in the medical literature about the importance of empathy and physician communication style in medical practice. Empathy has been shown to have a very real positive effect on patient outcomes. Most of the existing literature speaks to its role in medical education, with relatively little empiric study about empathy in the surgical setting. Review of empathy and its importance as it pertains to the surgeon-patient relationship and improving patient outcomes, and the need for increased education in empathy during surgical training. The published, peer-reviewed literature on patient-physician and patient-surgeon communication, medical student and resident education in empathy, and empathy research was reviewed. PubMed was queried for MESH terms including "empathy," "training," "education," "surgery," "resident," and "communication." There is evidence of a decline in empathy that begins during the clinical years of medical school, which continues throughout residency training. Surgeons are particularly susceptible to this decline as by-product of the nature of their work, and the current lack of formalised training in empathic patient communication poses a unique problem to surgical residents. The literature suggests that empathy training is warranted and should be incorporated into surgical residencies through didactics, role-playing and simulations, and apprenticeship to empathic attending role models. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  13. 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.

  14. Barriers to the implementation and uptake of simulation-based training programs in general surgery: a multinational qualitative study.

    Science.gov (United States)

    Hosny, Shady G; Johnston, Maximilian J; Pucher, Philip H; Erridge, Simon; Darzi, Ara

    2017-12-01

    Despite evidence demonstrating the advantages of simulation training in general surgery, it is not widely integrated into surgical training programs worldwide. The aim of this study was to identify barriers and facilitators to the implementation and uptake of surgical simulation training programs. A multinational qualitative study was conducted using semi-structured interviews of general surgical residents and experts. Each interview was audio recorded, transcribed verbatim, and underwent emergent theme analysis. All data were anonymized and results pooled. A total of 37 individuals participated in the study. Seventeen experts (Program Directors and Surgical Attendings with an interest in surgical education) and 20 residents drawn from the United States, Canada, United Kingdom, France, and Japan were interviewed. Barriers to simulation-based training were identified based on key themes including financial cost, access, and translational benefit. Participants described cost (89%) and access (76%) as principal barriers to uptake. Common facilitators included a mandatory requirement to complete simulation training (78%) and on-going assessment of skills (78%). Participants felt that simulation training could improve patient outcomes (76%) but identified a lack of evidence to demonstrate benefit (38%). There was a consensus that simulation training has not been widely implemented (70%). There are multiple barriers to the implementation of surgical simulation training programs, however, there is agreement that these programs could potentially improve patient outcomes. Identifying these barriers enable the targeted use of facilitators to deliver simulation training programs. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Cosmetic dermatologic surgical training in US dermatology residency programs: identifying and overcoming barriers.

    Science.gov (United States)

    Bauer, Bruce; Williams, Erin; Stratman, Erik J

    2014-02-01

    The public and other medical specialties expect dermatologists who offer cosmetic dermatology services to provide competent care. There are numerous barriers to achieving cosmetic dermatology competency during residency. Many dermatology residents enter the workforce planning to provide cosmetic services. If a training gap exists, this may adversely affect patient safety. To identify resources available for hands-on cosmetic dermatology training in US dermatology residency training programs and to assess program director (PD) attitudes toward cosmetic dermatology training during residency and strategies, including discounted pricing, used by training programs to overcome barriers related to resident-performed cosmetic dermatology procedures. An online survey in academic dermatology practices among PDs of US dermatology residency programs. Frequency of cosmetic dermatology devices and injectables used for dermatology resident hands-on cosmetic dermatology training, categorizing PD attitudes toward cosmetic dermatology training during residency and describing residency-related discounted pricing models. Responses from PDs were received from 53 of 114 (46%) US dermatology residency programs. All but 3 programs (94%) offered hands-on cosmetic dermatology training using botulinum toxin, and 47 of 53 (89%) provided training with hyaluronic acid fillers. Pulsed dye lasers represented the most common laser use experienced by residents (41 of 52 [79%]), followed by Q-switched Nd:YAG (30 of 52 [58%]). Discounted procedures were offered by 32 of 53 (60%) programs, with botulinum toxin (30 of 32 [94%]) and fillers (27 of 32 [84%]) most prevalent and with vascular lasers (17 of 32 [53%]) and hair removal lasers (12 of 32 [38%]) less common. Various discounting methods were used. Only 20 of 53 (38%) PDs believed that cosmetic dermatology should be a necessary aspect of residency training; 14 of 52 (27%) PDs thought that residents should not be required to perform any cosmetic

  16. 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.

  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. 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.

  19. 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.

  20. 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

  1. 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.

  2. 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

    -measures analysis of variance and Wilcoxon rank sum tests. Residents participated in 4.5 ± 1.4 sessions per academic year. Compliance with scheduled training was 88%, 90%, and 99% over successive years. Performance data were available for 39 PGY1, 2, and 3 residents. Ten individual residents could be followed between PGY1 and PGY2. For these individuals, improvement in mean performance was detected for the PGY2 (81% ± 5% vs 86% ± 4%; p 2 standard deviations below mean for the PGY level and 5 of these had deficiencies in clinical performance noted by other evaluation methods. Patient simulation training was implemented successfully with good compliance in this medium-sized surgical residency training program, but clear challenges were encountered with issues related to the number and range of experiences available per resident, competition with other educational activities, and fidelity and realism. Initial experience suggests that the associated assessment methods can detect predictable improvements in patient management skills across successive residency years, as well as potentially deficient management. Additional work is required to determine the educational effect of this training on resident clinical competency. Copyright © 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. Residency Training in Robotic General Surgery: A Survey of Program Directors.

    Science.gov (United States)

    George, Lea C; O'Neill, Rebecca; Merchant, Aziz M

    2018-01-01

    Robotic surgery continues to expand in minimally invasive surgery; however, the literature is insufficient to understand the current training process for general surgery residents. Therefore, the objectives of this study were to identify the current approach to and perspectives on robotic surgery training. An electronic survey was distributed to general surgery program directors identified by the Accreditation Council for Graduate Medical Education website. Multiple choice and open-ended questions regarding current practices and opinions on robotic surgery training in general surgery residency programs were used. 20 program directors were surveyed, a majority being from medium-sized programs (4-7 graduating residents per year). Most respondents (73.68%) had a formal robotic surgery curriculum at their institution, with 63.16% incorporating simulation training. Approximately half of the respondents believe that more time should be dedicated to robotic surgery training (52.63%), with simulation training prior to console use (84.21%). About two-thirds of the respondents (63.16%) believe that a formal robotic surgery curriculum should be established as a part of general surgery residency, with more than half believing that exposure should occur in postgraduate year one (55%). A formal robotics curriculum with simulation training and early surgical exposure for general surgery residents should be given consideration in surgical residency training.

  8. 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...

  9. 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.

  10. 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

  11. 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.

  12. 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...

  13. Residency Training in Robotic General Surgery: A Survey of Program Directors

    Directory of Open Access Journals (Sweden)

    Lea C. George

    2018-01-01

    Full Text Available Objective. Robotic surgery continues to expand in minimally invasive surgery; however, the literature is insufficient to understand the current training process for general surgery residents. Therefore, the objectives of this study were to identify the current approach to and perspectives on robotic surgery training. Methods. An electronic survey was distributed to general surgery program directors identified by the Accreditation Council for Graduate Medical Education website. Multiple choice and open-ended questions regarding current practices and opinions on robotic surgery training in general surgery residency programs were used. Results. 20 program directors were surveyed, a majority being from medium-sized programs (4–7 graduating residents per year. Most respondents (73.68% had a formal robotic surgery curriculum at their institution, with 63.16% incorporating simulation training. Approximately half of the respondents believe that more time should be dedicated to robotic surgery training (52.63%, with simulation training prior to console use (84.21%. About two-thirds of the respondents (63.16% believe that a formal robotic surgery curriculum should be established as a part of general surgery residency, with more than half believing that exposure should occur in postgraduate year one (55%. Conclusion. A formal robotics curriculum with simulation training and early surgical exposure for general surgery residents should be given consideration in surgical residency training.

  14. Surgeons' attitude toward a competency-based training and assessment program: results of a multicenter survey.

    Science.gov (United States)

    Hopmans, Cornelis J; den Hoed, Pieter T; Wallenburg, Iris; van der Laan, Lijkckle; van der Harst, Erwin; van der Elst, Maarten; Mannaerts, Guido H H; Dawson, Imro; van Lanschot, Jan J B; Ijzermans, Jan N M

    2013-01-01

    Currently, most surgical training programs are focused on the development and evaluation of professional competencies. Also in the Netherlands, competency-based training and assessment programs were introduced to restructure postgraduate medical training. The current surgical residency program is based on the Canadian Medical Education Directives for Specialists (CanMEDS) competencies and uses assessment tools to evaluate residents' competence progression. In this study, we examined the attitude of surgical residents and attending surgeons toward a competency-based training and assessment program used to restructure general surgical training in the Netherlands in 2009. In 2011, all residents (n = 51) and attending surgeons (n = 108) in 1 training region, consisting of 7 hospitals, were surveyed. Participants were asked to rate the importance of the CanMEDS competencies and the suitability of the adopted assessment tools. Items were rated on a 5-point Likert scale and considered relevant when at least 80% of the respondents rated an item with a score of 4 or 5 (indicating a positive attitude). Reliability was evaluated by calculating the Cronbach's α, and the Mann-Whitney test was applied to assess differences between groups. The response rate was 88% (n = 140). The CanMEDS framework demonstrated good reliability (Cronbach's α = 0.87). However, the importance of the competencies 'Manager' (78%) and 'Health Advocate' (70%) was undervalued. The assessment tools failed to achieve an acceptable reliability (Cronbach's α = 0.55), and individual tools were predominantly considered unsuitable for assessment. Exceptions were the tools 'in-training evaluation report' (91%) and 'objective structured assessment of technical skill' (82%). No significant differences were found between the residents and the attending surgeons. This study has demonstrated that, 2 years after the reform of the general surgical residency program, residents and attending surgeons in a large

  15. 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.

  16. 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.

  17. 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.

  18. [Training program in endourological surgery. Future perspectives.

    Science.gov (United States)

    Soria, Federico; Villacampa, Felipe; Serrano, Alvaro; Moreno, Jesús; Rioja, Jorge; Sánchez, Francisco Miguel

    2018-01-01

    Current training in urological endoscopy lacks a specific training program. However, there is a clear need for a specific and uniform program, which will ensure the training, regardless of the unit where it is carried out. So, the goal is to first evaluate the current model and then bring improvements for update. The hospital training accreditation programme are only the adjustment of the official program of the urology specialty to the specific circumstances of each center, which causes variability in training of residents. After reviewing 19 training programs belonging to 12 Spanish regions. The current outlook shows that scarcely 10% of hospitals quantify the number of procedures/ year, although the Spanish program emphasizes that the achievement of the residents should be quantified. Urology residents, sense their training as inadequate and therefore their level of satisfaction is moderate. The three main problems detected by residents as an obstacle on their training are: the lack of supervision, tutors completing their own learning. Finally, the lack of quantification in surgical activities is described as a threat. This has no easy solution, since the learning curve of the most common techniques in endourology is not correctly established. Regarding aspects that can improve the current model, they highlight the need to design a specific program. The need to customize the training, the ineludible accreditation of tutors and obviously dignify the tutor's teaching activity. Another basic aspect is the inclusion of new technologies as training tools, e-learning. As well as the implementation of an adequate competency assessment plan and the possibility of relying on simulation systems. Finally, they highlight the need to attend monographic meetings and external clinic rotations to promote critical training.

  19. 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.

  20. 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.

  1. 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.

  2. Coalition for Global Clinical Surgical Education: The Alliance for Global Clinical Training.

    Science.gov (United States)

    Graf, Jahanara; Cook, Mackenzie; Schecter, Samuel; Deveney, Karen; Hofmann, Paul; Grey, Douglas; Akoko, Larry; Mwanga, Ali; Salum, Kitembo; Schecter, William

    Assessment of the effect of the collaborative relationship between the high-income country (HIC) surgical educators of the Alliance for Global Clinical Training (Alliance) and the low-income country surgical educators at the Muhimbili University of Health and Allied Sciences/Muhimbili National Hospital (MUHAS/MNH), Dar Es Salaam, Tanzania, on the clinical global surgery training of the HIC surgical residents participating in the program. A retrospective qualitative analysis of Alliance volunteer HIC faculty and residents' reports, volunteer case lists and the reports of Alliance academic contributions to MUHAS/MNH from 2012 to 2017. In addition, a survey was circulated in late 2016 to all the residents who participated in the program since its inception. Twelve HIC surgical educators provided rotating 1-month teaching coverage at MUHAS/MNH between academic years 2012 and 2017 for a total of 21 months. During the same time period 11 HIC residents accompanied the HIC faculty for 1-month rotations. HIC surgery residents joined the MUHAS/MNH Department of Surgery, made significant teaching contributions, performed a wide spectrum of "open procedures" including hand-sewn intestinal anastomoses. Most had had either no or limited previous exposure to hand-sewn anastomoses. All of the residents commented that this was a maturing and challenging clinical rotation due to the complexity of the cases, the limited resources available and the ethical and emotional challenges of dealing with preventable complications and death in a resource constrained environment. The Alliance provides an effective clinical global surgery rotation at MUHAS/MNH for HIC Surgery Departments wishing to provide such an opportunity for their residents and faculty. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  3. 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

  4. 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.

  5. What evidence is there for the use of workplace-based assessment in surgical training?

    Science.gov (United States)

    Shalhoub, Joseph; Vesey, Alex Thomas; Fitzgerald, James Edward Frankland

    2014-01-01

    Recent years have seen broad changes in postgraduate training with a move toward structured formative and summative evaluation of trainees' competencies using workplace-based assessment (WBA) tools. The fitness for purpose of these instruments in surgery has been much debated. The aim of this study is to explore the evidence underlying the introduction and ongoing use of WBAs in surgical training. A critical literature review was conducted to identify studies evaluating the use of WBAs in postgraduate surgical training. The search was conducted using the electronic databases PubMed for full-text articles in English. Additional critical evaluations of the curriculum relating to WBAs were included. The articles were synthesized in a narrative review. The implementation of WBA requirements in surgical training has occurred despite a relative dearth of direct evidence of their efficacy and benefit. Studies and critical reviews are being regularly undertaken to ensure that supporting evidence is accrued and the drive for improvement and refinement is maintained. It is emerging that WBAs are (contrary to their current nomenclature) formative tools for feedback and hence learning. They can facilitate the progression toward expert practice at the center of the zone of proximal development and the higher levels of Miller's pyramid, but fall short--owing to their focus on competence--of guiding surgical trainees to the higher levels of Maslow's hierarchy. Limited evidence has potentially undermined the introduction of WBAs in surgical training to date. There are misunderstandings regarding their use as either summative or formative educational tools. These shortcomings are an opportunity for further work in examining WBAs in their current or modified form. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2016-09-01

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

  7. 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.

  8. [Quality of surgical continuing education in Germany].

    Science.gov (United States)

    Ansorg, J; Hassan, I; Fendrich, V; Polonius, M J; Rothmund, M; Langer, P

    2005-03-11

    One of the reasons for young doctors to leave the clinical work to go abroad or into non-clinical fields is insufficient quality of training under bad circumstances. Aim of the study was to evaluate the surgical training in Germany from the viewpoint of the residents. A questionnaire was prepared by residents and consultants and approved by the German surgical societies (Deutsche Gesellschaft fur Chirurgie und Berufsverband der Deutschen Chirurgen). It was sent to surgical residents between June 2003 and June 2004, published in "Der Chirurg BDC" and distributed among residents taking part in courses conducted by the BDC. It could be answered anonymously by email, mail or online. The questionnaire was sent back by 584 surgical residents (about 30 % of all). 58 % of the residents declared that they finished the training in the intended time (6 years). Rotation-systems as part of a structured residency program existed for 43 %. Standard surgical procedures were discussed or explained before the procedure in only 46 %. 61 % of the residents were not satisfied with the teaching assistance by their clinical teachers in the OR. Only 33 % had regular talks with the Chief about their progress in surgical training. 18 % of residents felt, that the hospital is interested in their progress in training. Indication-conferences took place in 52 % and mortality-conferences in only 20 % of programs. Regular seminars on recent issues took place in 62 %, and 61 % of residents did not get financial support to attend congresses. 36 % of residents had to use their holidays to attend congresses. Surgical training structures are not well established in about 50 % of the training hospitals from where we got answers to our survey. The training potential of daily surgical work is not used appropriately. It is therefore imperative to develop guidelines for surgical training, the use of log-books and rotation-programs.

  9. Royal College surgical objectives of urologic training: A survey of faculty members from Canadian training programs

    Science.gov (United States)

    Zakaria, Ahmed S.; Haddad, Richard; Dragomir, Alice; Kassouf, Wassim; Andonian, Sero; Aprikian, Armen G.

    2014-01-01

    Introduction: According to the Royal College objectives of training in urology, urologic surgical procedures are divided as category A, B and C. We wanted to determine the level of proficiency required and achieved by urology training faculty for Royal College accreditation. Methods: We conducted a survey that was sent electronically to all Canadian urology training faculty. Questions focused on demographics (i.e., years of practice, geographic location, subspecialty, access to robotic surgery), operating room contact with residents, opinion on the level of proficiency required from a list of 54 surgical procedures, and whether their most recent graduates attained category A proficiency in these procedures. Results: The response rate was 43.7% (95/217). Among respondents, 92.6% were full timers, 21.1% practiced urology for less than 5 years and 3.2% for more than 30 years. Responses from Quebec and Ontario formed 69.4% (34.7% each). Of the respondents, 37.9% were uro-oncologists and 75.7% reported having access to robotic surgery. Sixty percent of faculty members operate with R5 residents between 2 to 5 days per month. When respondents were asked which categories should be listed as category A, only 8 procedures received 100% agreement. Also, results varied significantly when analyzed by sub-specialty. For example, almost 50% or more of uro-oncologists believed that radical cystectomy, anterior pelvic exenteration and extended pelvic lymphadenectomy should not be category A. The following procedures had significant disagreement suggesting the need for re-classification: glanular hypospadias repair, boari flap, entero-vesical and vesicovaginal fistulae repair. Overall, more than 80% of faculty reported that their recent graduating residents had achieved category A proficiency, in a subset of procedures. However, more than 50% of all faculty either disagreed or were ambivalent that all of their graduating residents were Category A proficient in several procedures

  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. 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.

  12. Attitudes and factors contributing to attrition in Canadian surgical specialty residency programs.

    Science.gov (United States)

    Adams, Simon; Ginther, David Nathan; Neuls, Evan; Hayes, Paul

    2017-08-01

    We recently studied attrition in Canadian general surgical programs; however, there are no data on whether residents enrolled in other surgical residencies harbour the same intents as their general surgical peers. We sought to determine how many residents in surgical disciplines in Canada consider leaving their programs and why. An anonymous survey was administered to all residents in 9 surgical disciplines in Canada. Significance of association was determined using the Pearson χ2 test. The Canadian Post-MD Education Registry (CAPER) website was used to calculate the response rate. We received 523 responses (27.6% response rate). Of these respondents, 140 (26.8%) were either "somewhat" or "seriously" considering leaving their program. Residents wanting to pursue additional fellowship training and those aspiring to an academic career were significantly less likely to be considering changing specialties ( p = 0.003 and p = 0.005, respectively). Poor work-life balance and fear of unemployment/underemployment were the top reasons why residents would change specialty (55.5% and 40.8%, respectively), although the reasons cited were not significantly different between those considering changing and those who were not ( p = 0.64). Residents who were considering changing programs were significantly less likely to enjoy their work and more likely to cite having already invested too much time to change as a reason for continuing ( p work-life balance and limited employment prospects. Efforts to educate prospective residents about the reality of the surgical lifestyle and to optimize employment prospects may improve completion rates.

  13. [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

  14. 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.

  15. Part-time general surgical training in South Australia: its success and future implications (or: pinnacles, pitfalls and lessons for the future).

    Science.gov (United States)

    Neuhaus, Susan; Igras, Emma; Fosh, Beverley; Benson, Sarah

    2012-12-01

    Flexible training options are sought by an increasing number of Australasian surgical trainees. Reasons include increased participation of women in the surgical workforce, postgraduate training and changing attitudes to family responsibilities. Despite endorsement of flexible training by the Royal Australasian College of Surgeons and Board in General Surgery, part-time (PT) training in General Surgery in Australia and New Zealand is not well established. A permanent 'stand-alone' PT training position was established at the Royal Adelaide Hospital in 2007 under the Surgical Education and Training Program. This position offered 12 months of General Surgical training on a 0.5 full-time (FT) equivalent basis with pro rata emergency and on-call commitments and was accredited for 6 months of General Surgical training. This paper reviews the PT training experience in South Australia. De-identified logbook data were obtained from the South Australian Regional Subcommittee of the Board in General Surgery with consent of each of the trainees. Totals of operative cases were compared against matched FT trainees working on the same unit. Overall, PT trainees achieved comparable operative caseloads compared with their FT colleagues. All trainees included in this review have subsequently passed the Royal Australasian College of Surgeons Fellowship Examination in General Surgery and returned to FT workforce positions. This paper presents two validated models of PT training. Training, resource and regulatory requirements and individual and institutional barriers to flexible training are substantial. Successful PT models offer positive and beneficial training alternatives for General Surgical trainees and contribute to workforce flexibility. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  16. 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

  17. 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.

  18. "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.

  19. 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.

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

    Science.gov (United States)

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

    2013-05-06

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

  1. 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.

  2. The first cut is the deepest: basic surgical training in ophthalmology.

    Science.gov (United States)

    Gibson, A; Boulton, M G; Watson, M P; Moseley, M J; Murray, P I; Fielder, A R

    2005-12-01

    To examine the basic surgical training received by Senior House Officers (SHOs) in ophthalmology and the influence on training of sociodemographic and organisational factors. Cross-sectional survey of SHOs in recognised UK surgical training posts asking about laboratory training and facilities, surgical experience, demographic details, with the opportunity to add comments. A total of 314/466 (67%) questionnaires were returned. In all, 67% had attended a basic surgical course, 40% had access to wet labs and 39% had spent time in a wet lab in the previous 6 months. The mean number of part phakoemulsification (phako) procedures performed per week was 0.79; the mean number of full phakos performed per week was 0.74. The number of part phakos performed was negatively correlated, and the number of full phakos completed was positively correlated, with length of time as an SHO. Respondents who had larger operating lists performed more full phakos per week (Pwomen were less likely to have access to a wet lab (P=0.013), had completed fewer full phakos per week (P=0.003), and were less likely to have completed 50 full phakos (P=0003). SHOs' comments revealed concerns about their limited 'hands on' experience. There are significant shortcomings in the basic surgical training SHOs receive, particularly in relation to wet lab experience and opportunities to perform full intraocular procedures. SHOs themselves perceive their training as inadequate. Women are disadvantaged in both laboratory and patient-based training, but minority ethnic groups and those who qualified overseas are not.

  3. Perceptions of gender-based discrimination during surgical training and practice

    OpenAIRE

    Bruce, Adrienne N.; Battista, Alexis; Plankey, Michael W.; Johnson, Lynt B.; Marshall, M. Blair

    2015-01-01

    Background: Women represent 15% of practicing general surgeons. Gender-based discrimination has been implicated as discouraging women from surgery. We sought to determine women’s perceptions of gender-based discrimination in the surgical training and working environment.Methods: Following IRB approval, we fielded a pilot survey measuring perceptions and impact of gender-based discrimination in medical school, residency training, and surgical practice. It was sent electronically to 1,065 indiv...

  4. 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.

  5. Can surgical simulation be used to train detection and classification of neural networks?

    Science.gov (United States)

    Zisimopoulos, Odysseas; Flouty, Evangello; Stacey, Mark; Muscroft, Sam; Giataganas, Petros; Nehme, Jean; Chow, Andre; Stoyanov, Danail

    2017-10-01

    Computer-assisted interventions (CAI) aim to increase the effectiveness, precision and repeatability of procedures to improve surgical outcomes. The presence and motion of surgical tools is a key information input for CAI surgical phase recognition algorithms. Vision-based tool detection and recognition approaches are an attractive solution and can be designed to take advantage of the powerful deep learning paradigm that is rapidly advancing image recognition and classification. The challenge for such algorithms is the availability and quality of labelled data used for training. In this Letter, surgical simulation is used to train tool detection and segmentation based on deep convolutional neural networks and generative adversarial networks. The authors experiment with two network architectures for image segmentation in tool classes commonly encountered during cataract surgery. A commercially-available simulator is used to create a simulated cataract dataset for training models prior to performing transfer learning on real surgical data. To the best of authors' knowledge, this is the first attempt to train deep learning models for surgical instrument detection on simulated data while demonstrating promising results to generalise on real data. Results indicate that simulated data does have some potential for training advanced classification methods for CAI systems.

  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. 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.

  8. "Run-through" training at specialist training year 1 and uncoupled core surgical training for oral and maxillofacial surgery in the United Kingdom: a snapshot survey.

    Science.gov (United States)

    Garg, M; Collyer, J; Dhariwal, D

    2018-05-01

    Training in oral and maxillofacial surgery (OMFS) in the UK has undergone considerable changes during the last 10years, and "core" surgical training has replaced "basic" surgical training. In 2014 a pilot "run-through" training programme from specialist training year one (ST1)-ST7 was introduced to facilitate early entry into the speciality. Run-through training guarantees that a trainee, after a single competitive selection process and satisfactory progress, will be given training that covers the entire curriculum of the speciality, whereas uncoupled training requires a second stage of competitive recruitment after the first one (for OMFS only) or two years of "core" training to progress to higher specialty training. The first two years of run-through training (ST1-ST2) are the same as for core surgical training. Dual-qualified maxillofacial aspirants and those in their second degree course are curious to know whether they should go for the uncoupled core surgical training or the run-through programme in OMFS. The General Medical Council (GMC) has now agreed that run-through training can be rolled out nationally in OMFS. To assess the two pathways we used an online questionnaire to gain feedback about the experience from all OMFS ST3 and run-through trainees (ST3/ST4) in 2016-2017. We identified and contacted 21 trainees, and 17 responded, including seven run-through trainees. Eleven, including five of the run-through trainees, recommended the run-through training programme in OMFS. Six of the seven run-through trainees had studied dentistry first. The overall mean quality of training was rated as 5.5 on a scale 0-10 by the 17 respondents. This survey gives valuable feedback from the current higher surgical trainees in OMFS, which will be useful to the GMC, Health Education England, OMFS Specialist Advisory Committee, and those seeking to enter higher surgical training in OMFS. Copyright © 2018 The British Association of Oral and Maxillofacial Surgeons. Published

  9. 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.

  10. American Pediatric Surgical Association

    Science.gov (United States)

    American Pediatric Surgical Association Search for: Login Resources + For Members For Professionals For Training Program Directors For Media For ... Surgical Outcomes Surveys & Results Publications Continuing Education + ExPERT Pediatric Surgery NaT Annual Meeting CME MOC Requirements Residents / ...

  11. The European Working Time Directive and the effects on training of surgical specialists (doctors in training): a position paper of the surgical disciplines of the countries of the EU.

    Science.gov (United States)

    Benes, V

    2006-11-01

    Legislation launched with the EWTD was born as a "Protection of the clinical personnel against overwork for the benefit of Patients" (consumer protection and safety). It appeared that this legislation is in direct and severe conflict with former EU legislation to train competent surgical specialists. First experiences with the EWTD show far reaching and serious consequences on the training of surgical specialists as well as on medical care. There will be a reduction of about 30-35% of clinical and operative experience acquired during the usual 6 yrs of training, with many other negative aspects (see p. 7). All measures proposed so far to overcome the ensuing problems are unworkable. The training of competent surgical specialists as required by the Directive 93/16 EEC is no longer possible and serious problems with safe patient care will occur in the short term, if no political actions are taken. The surgical specialties, represented in the UEMS, provide a proposal for a working hour model consisting of 48 hrs working time (incl. service duties) plus additional 12 hrs reserved and protected for teaching and training. This model would adhere to the EWTD on the one hand, yet maintain the desired standard of training. This proposed exemption from the EWTD would be limited to the time of specialist training. We ask the responsible politicians to find a solution rapidly to prevent serious negative consequences. This motion is supported by the surgical specialties (neurosurgery, general surgery, orthopaedic surgery, paediatric surgery, cardio-thoracic surgery, vascular surgery, oto-rhino-laryngology, list not complete) of the member states of the EU, representing more than 80,000 surgical specialists.

  12. Current status of endoscopic simulation in gastroenterology fellowship training programs.

    Science.gov (United States)

    Jirapinyo, Pichamol; Thompson, Christopher C

    2015-07-01

    Recent guidelines have encouraged gastroenterology and surgical training programs to integrate simulation into their core endoscopic curricula. However, the role that simulation currently has within training programs is unknown. This study aims to assess the current status of simulation among gastroenterology fellowship programs. This questionnaire study consisted of 38 fields divided into two sections. The first section queried program directors' experience on simulation and assessed the current status of simulation at their institution. The second portion surveyed their opinion on the potential role of simulation on the training curriculum. The study was conducted at the 2013 American Gastroenterological Association Training Directors' Workshop in Phoenix, Arizona. The participants were program directors from Accreditation Council for Graduate Medical Education accredited gastroenterology training programs, who attended the workshop. The questionnaire was returned by 69 of 97 program directors (response rate of 71%). 42% of programs had an endoscopic simulator. Computerized simulators (61.5%) were the most common, followed by mechanical (30.8%) and animal tissue (7.7%) simulators, respectively. Eleven programs (15%) required fellows to use simulation prior to clinical cases. Only one program has a minimum number of hours fellows have to participate in simulation training. Current simulators are deemed as easy to use (76%) and good educational tools (65%). Problems are cost (72%) and accessibility (69%). The majority of program directors believe that there is a need for endoscopic simulator training, with only 8% disagreeing. Additionally, a majority believe there is a role for simulation prior to initiation of clinical cases with 15% disagreeing. Gastroenterology fellowship program directors widely recognize the importance of simulation. Nevertheless, simulation is used by only 42% of programs and only 15% of programs require that trainees use simulation prior to

  13. Open abdominal surgical training differences experienced by integrated vascular and general surgery residents.

    Science.gov (United States)

    Tanious, Adam; Wooster, Mathew; Jung, Andrew; Nelson, Peter R; Armstrong, Paul A; Shames, Murray L

    2017-10-01

    As the integrated vascular residency program reaches almost a decade of maturity, a common area of concern among trainees is the adequacy of open abdominal surgical training. It is our belief that although their overall exposure to open abdominal procedures has decreased, integrated vascular residents have an adequate and focused exposure to open aortic surgery during training. National operative case log data supplied by the Accreditation Council for Graduate Medical Education were compiled for both graduating integrated vascular surgery residents (IVSRs) and graduating categorical general surgery residents (GSRs) for the years 2012 to 2014. Mean total and open abdominal case numbers were compared between the IVSRs and GSRs, with more in-depth exploration into open abdominal procedures by organ system. Overall, the mean total 5-year case volume of IVSRs was 1168 compared with 980 for GSRs during the same time frame (P surgery, representing 57% of all open abdominal cases. GSRs completed an average of 116 open alimentary tract surgeries during their training. Open abdominal surgery represented an average of 7.1% of the total vascular case volume for the vascular residents, whereas open abdominal surgery represented 21% of a GSR's total surgical experience. IVSRs reported almost double the number of total cases during their training, with double chief-level cases. Sixty-five percent of open abdominal surgeries performed by IVSRs involved the aorta or its renovisceral branches. Whereas open abdominal surgery represented 7.1% of an IVSR's surgical training, GSRs had a far broader scope of open abdominal procedures, completing nearly double those of IVSRs. The differences in open abdominal procedures pertain to the differing diseases treated by GSRs and IVSRs. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  14. 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.

  15. Best practices across surgical specialties relating to simulation-based training.

    Science.gov (United States)

    Gardner, Aimee K; Scott, Daniel J; Pedowitz, Robert A; Sweet, Robert M; Feins, Richard H; Deutsch, Ellen S; Sachdeva, Ajit K

    2015-11-01

    Simulation-based training is playing an increasingly important role in surgery. However, there is insufficient discussion among the surgical specialties regarding how simulation may best be leveraged for training. There is much to be learned from one another as we all strive to meet new requirements within the context of Undergraduate Medical Education, Graduate Medical Education, and Continuing Medical Education. To address this need, a panel was convened at the 6th Annual Meeting of the Consortium of the American College of Surgeons-Accredited Education Institutes consisting of key leaders in the field of simulation from 4 surgical subspecialties, namely, general surgery, orthopedic surgery, cardiothoracic surgery, urology, and otolaryngology. An overview of how the 5 surgical specialties are using simulation-based training to meet a wide array of educational needs for all levels of learners is presented. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. 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

  17. [Structured residency training program for otolaryngology: a trendsetting principle].

    Science.gov (United States)

    Meyer, J E; Wollenberg, B; Schmidt, C

    2008-09-01

    A concept for an ORL residency training program is necessary because of personnel bottlenecks, quality assurance and benchmarkings. We have created a 2.5 years' program, which is based on 6 pillars: 1. Acquisition of the necessary specialist knowledge by the resident in self-study. 2. Weekly attendance of training lectures according to a study timetable, a monthly specialist seminar to discuss case examples. 3. Weekly presentation by the resident on an article from the current literature, alternating with a presentation on cases and a morbidity and mortality conference. 4. Annual 60 min learning target test. 5. Definition of a surgical training calendar oriented to the new national ORL training regulations. 6. Internal operation course with preparative exercises in anatomy and visit to an operations course at a renowned otolaryngology clinic each year. After 2.5 years of the training time a revision course is introduced. In this way a basic training will be guaranteed for all residents, which can be assessed by the annual test. Finally, the construction of a further training curriculum should lead to an improved transparent training, a higher standard of quality and improved staff satisfaction.

  18. 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.

  19. Operative time and cost of resident surgical experience: effect of instituting an otolaryngology residency program.

    Science.gov (United States)

    Pollei, Taylor R; Barrs, David M; Hinni, Michael L; Bansberg, Stephen F; Walter, Logan C

    2013-06-01

    Describe the procedure length difference between surgeries performed by an attending surgeon alone compared with the resident surgeon supervised by the same attending surgeon. Case series with chart review. Tertiary care center and residency program. Six common otolaryngologic procedures performed between August 1994 and May 2012 were divided into 2 cohorts: attending surgeon alone or resident surgeon. This division coincided with our July 2006 initiation of an otolaryngology-head and neck surgery residency program. Operative duration was compared between cohorts with confounding factors controlled. In addition, the direct result of increased surgical length on operating room cost was calculated and applied to departmental and published resident case log report data. Five of the 6 procedures evaluated showed a statistically significant increase in surgery length with resident involvement. Operative time increased 6.8 minutes for a cricopharyngeal myotomy (P = .0097), 11.3 minutes for a tonsillectomy (P operative time difference. Cost of increased surgical time was calculated per surgery and ranged from $286 (cricopharyngeal myotomy) to $2142 (mastoidectomy). When applied to reported national case log averages for graduating residents, this resulted in a significant increase of direct training-related costs. Resident participation in the operating room results in increased surgical length and additional system cost. Although residency is a necessary part of surgical training, associated costs need to be acknowledged.

  20. Building a Sustainable Global Surgical Program in an Academic Department of Surgery.

    Science.gov (United States)

    Zhang, Linda P; Silverberg, Daniel; Divino, Celia M; Marin, Michael

    Global surgery and volunteerism in surgery has gained significant interest in recent years for general surgery residents across the country. However, there are few well-established long-term surgical programs affiliated with academic institutions. The present report discusses the implementation process and challenges facing an academic institution in building a long-term sustainable global surgery program. As one of the pioneer programs in global surgery for residents, the Icahn School of Medicine at Mount Sinai global surgery rotation has been successfully running for the last 10 years in a small public hospital in the Dominican Republic. The present report details many key components of implementing a sustainable global surgery program and the evolution of this program over time. Since 2005, 80 general surgery residents have rotated through Juan Pablo Pina Hospital in the Dominican Republic. They have performed a total of 1239 major operations and 740 minor operations. They have also participated in 328 emergency cases. More importantly, this rotation helped shape residents' sense of social responsibility and ownership in their surgical training. Residents have also contributed to the training of local residents in laparoscopic skills and through cultural exchange. As interest in global surgery grows among general surgery residents, it is essential that supporting academic institutions create sustainable and capacity-building rotations for their residents. These programs must address many of the barriers that can hinder maintenance of a sustainable global surgery experience for residents. After 10 years of sending our residents to the Dominican Republic, we have found that it is possible and valuable to incorporate a formal global surgery rotation into a general surgery residency. Copyright © 2016. Published by Elsevier Inc.

  1. Dedicated training program for shoulder sonography: the results of a quality program reverberate with everyone.

    Science.gov (United States)

    Delzell, Patricia B; Boyle, Alex; Schneider, Erika

    2015-06-01

    The purpose of this study was to define and report on the effect of a comprehensive musculoskeletal sonography training program to improve accuracy (sensitivity and specificity) for the diagnosis of rotator cuff tears in relatively inexperienced operators. Before the training program was implemented, radiologists (n = 12) had a mean of 2 years (range, training shoulder sonographic results were compared to surgical reports or, in their absence, to shoulder magnetic resonance imaging or computed tomographic arthrographic results if within 2 months of the sonographic examination. A total of 82 patients were included in the pre-training group (January 2010-December 2011), and 50 patients were included in the post-training group (January 2012-June 2013). The accuracy, sensitivity, specificity, and positive and negative predictive values were determined for the presence or absence of supraspinatus and infraspinatus tendon tears. After implementation of the training program, the sensitivity of sonography for detecting full-thickness rotator cuff tears increased by 14%, and the sensitivity for detecting partial-thickness rotator cuff tears increased by 3%. Quality improvement programs and acquisition standardization along with ongoing, focused case conferences for the entire care team increased the sensitivity of shoulder sonography for diagnosing both full- and partial-thickness rotator cuff tears, independent of the years of operator experience. © 2015 by the American Institute of Ultrasound in Medicine.

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. 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

  7. Lost opportunity cost of surgical training in the Australian private sector.

    Science.gov (United States)

    Aitken, R James

    2012-03-01

    To meet Australia's future demands, surgical training in the private sector will be required. The aim of this study was to estimate the time and lost opportunity cost of training in the private sector. A literature search identified studies that compared the operation time required by a supervised trainee with a consultant. This time was costed using a business model. In 22 studies (34 operations), the median operation duration of a supervised trainee was 34% longer than the consultant. To complete a private training list in the same time as a consultant list, one major case would have to be dropped. A consultant's average lost opportunity cost was $1186 per list ($106,698 per year). Training in rooms and administration requirements increased this to $155,618 per year. To train 400 trainees in the private sector to college standards would require 54,000 training lists per year. The consultants' national lost opportunity cost would be $137 million per year. The average lost hospital case payment was $5894 per list, or $330 million per year nationally. The total lost opportunity cost of surgical training in the private sector would be about $467 million per year. When trainee salaries, other specialties and indirect expenses are included, the total cost will be substantially greater. It is unlikely that surgeons or hospitals will be prepared to absorb these costs. There needs to be a public debate about the funding implications of surgical training in the private sector. © 2012 The Author. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  8. 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.

  9. 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

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

    Science.gov (United States)

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

    2015-01-01

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

  11. 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.

  12. Surgical specialty procedures in rural surgery practices: implications for rural surgery training.

    Science.gov (United States)

    Sticca, Robert P; Mullin, Brady C; Harris, Joel D; Hosford, Clint C

    2012-12-01

    Specialty procedures constitute one eighth of rural surgery practice. Currently, general surgeons intending to practice in rural hospitals may not get adequate training for specialty procedures, which they will be expected to perform. Better definition of these procedures will help guide rural surgery training. Current Procedural Terminology codes for all surgical procedures for 81% of North Dakota and South Dakota rural surgeons were entered into the Dakota Database for Rural Surgery. Specialty procedures were analyzed and compared with the Surgical Council on Resident Education curriculum to determine whether general surgery training is adequate preparation for rural surgery practice. The Dakota Database for Rural Surgery included 46,052 procedures, of which 5,666 (12.3%) were specialty procedures. Highest volume specialty categories included vascular, obstetrics and gynecology, orthopedics, cardiothoracic, urology, and otolaryngology. Common procedures in cardiothoracic and vascular surgery are taught in general surgical residency, while common procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology are usually not taught in general surgery training. Optimal training for rural surgery practice should include experience in specialty procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Training Accreditation Program

    International Nuclear Information System (INIS)

    1989-01-01

    The Training Accreditation Program establishes the objectives and criteria against which DOE nuclear facility training is evaluated to determine its readiness for accreditation. Training programs are evaluated against the accreditation objectives and criteria by facility personnel during the initial self-evaluation process. From this self-evaluation, action plans are made by the contractor to address the scope of work necessary in order to upgrade any deficiencies noted. This scope of work must be formally documented in the Training Program Accreditation Plan. When reviewed and approved by the responsible Head of the Field Organization and cognizant Program Secretarial Office, EH-1 concurrence is obtained. This plan then becomes the document which guides accreditation efforts for the contractor

  14. 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

  15. Practice management education during surgical residency.

    Science.gov (United States)

    Jones, Kory; Lebron, Ricardo A; Mangram, Alicia; Dunn, Ernest

    2008-12-01

    Surgical education has undergone radical changes in the past decade. The introductions of laparoscopic surgery and endovascular techniques have required program directors to alter surgical training. The 6 competencies are now in place. One issue that still needs to be addressed is the business aspect of surgical practice. Often residents complete their training with minimal or no knowledge on coding of charges or basic aspects on how to set up a practice. We present our program, which has been in place over the past 2 years and is designed to teach the residents practice management. The program begins with a series of 10 lectures given monthly beginning in August. Topics include an introduction to types of practices available, negotiating a contract, managed care, and marketing the practice. Both medical and surgical residents attend these conferences. In addition, the surgical residents meet monthly with the business office to discuss billing and coding issues. These are didactic sessions combined with in-house chart reviews of surgical coding. The third phase of the practice management plan has the coding team along with the program director attend the outpatient clinic to review in real time the evaluation and management coding of clinic visits. Resident evaluations were completed for each of the practice management lectures. The responses were recorded on a Likert scale. The scores ranged from 4.1 to 4.8 (average, 4.3). Highest scores were given to lectures concerning negotiating employee agreements, recruiting contracts, malpractice insurance, and risk management. The medical education department has tracked resident coding compliance over the past 2 years. Surgical coding compliance increased from 36% to 88% over a 12-month period. The program director who participated in the educational process increased his accuracy from 50% to 90% over the same time period. When residents finish their surgical training they need to be ready to enter the world of business

  16. 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.

  17. Association of Program Directors in Vascular Surgery (APDVS) survey of program selection, knowledge acquisition, and education provided as viewed by vascular trainees from two different training paradigms.

    Science.gov (United States)

    Dalsing, Michael C; Makaroun, Michel S; Harris, Linda M; Mills, Joseph L; Eidt, John; Eckert, George J

    2012-02-01

    Methods of learning may differ between generations and even the level of training or the training paradigm, or both. To optimize education, it is important to optimize training designs, and the perspective of those being trained can aid in this quest. The Association of Program Directors in Vascular Surgery leadership sent a survey to all vascular surgical trainees (integrated [0/5], independent current and new graduates [5 + 2]) addressing various aspects of the educational experience. Of 412 surveys sent, 163 (∼40%) responded: 46 integrated, 96 fellows, and 21 graduates. The survey was completed by 52% of the integrated residents, 59% of the independent residents, and 20% of the graduates. When choosing a program for training, the integrated residents are most concerned with program atmosphere and the independent residents with total clinical volume. Concerns after training were thoracic and thoracoabdominal aneurysm procedures and business aspects: 40% to 50% integrated, and 60% fellows/graduates. Integrated trainees found periprocedural discussion the best feedback (79%), with 9% favoring written test review. Surgical training and vascular laboratory and venous training were judged "just right" by 87% and ∼71%, whereas business aspects needed more emphasis (65%-70%). Regarding the 80-hour workweek, 82% felt it prevented fatigue, and 24% thought it was detrimental to patient care. Independent program trainees also found periprocedural discussion the best feedback (71%), with 12% favoring written test review. Surgical training and vascular laboratory/venous training were "just right" by 87% and 60% to 70%, respectively, whereas business aspects needed more emphasis (∼65%-70%). Regarding the 80-hour workweek, 62% felt it was detrimental to patient care, and 42% felt it prevented fatigue. A supportive environment and adequate clinical volume will attract trainees to a program. For "an urgent need to know," the integrated trainees are especially turning to

  18. [Student program, congress grants and their potential influence on surgical career selection].

    Science.gov (United States)

    Jähne, J; Mittelstädt, A; Götzky, K

    2017-11-01

    Due to a decreased interest in surgical training the German Society of Surgery (GSS) has provided a specially sponsored student program at its annual clinical congress for many years in order to increase the number of applicants for a career in surgery. It remains unclear if this goal is reached because an evaluation has not yet been performed. At the clinical congress in 2014, 200 medical students participated in a special student program with the aid of a congress grant totaling 100,000 €. By means of a questionnaire it was asked how many of the participants in this special program have started a residency in surgery. Almost 17% of the participants of the student program answered and 13 students (6.5% of all participants) stated that they had started a surgical residency. All of these students claimed an interest in surgery even before participation in the congress. Those students who had not yet decided what kind of residency they should choose did not vote for surgery despite their visit to the congress. The student program and the congress grant at the annual clinical congress of the GSS do not result in an increased number of applicants for a residency in surgery. Both incentives might be not more than a strategic marketing instrument. An increased number of medical students applying for a residency in surgery is only to be expected if social developments (e. g. attention to a work-life balance) and their concomitant challenges are reflected in surgical day to day work.

  19. 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.

  20. Higher surgical training opportunities in the general hospital setting; getting the balance right.

    Science.gov (United States)

    Robertson, I; Traynor, O; Khan, W; Waldron, R; Barry, K

    2013-12-01

    The general hospital can play an important role in training of higher surgical trainees (HSTs) in Ireland and abroad. Training opportunities in such a setting have not been closely analysed to date. The aim of this study was to quantify operative exposure for HSTs over a 5-year period in a single institution. Analysis of electronic training logbooks (over a 5-year period, 2007-2012) was performed for general surgery trainees on the higher surgical training programme in Ireland. The most commonly performed adult and paediatric procedures per trainee, per year were analysed. Standard general surgery operations such as herniae (average 58, range 32-86) and cholecystectomy (average 60, range 49-72) ranked highly in each logbook. The most frequently performed emergency operations were appendicectomy (average 45, range 33-53) and laparotomy for acute abdomen (average 48, range 10-79). Paediatric surgical experience included appendicectomy, circumcision, orchidopexy and hernia/hydrocoele repair. Overall, the procedure most commonly performed in the adult setting was endoscopy, with each trainee recording an average of 116 (range 98-132) oesophagogastroduodenoscopies and 284 (range 227-354) colonoscopies. General hospitals continue to play a major role in the training of higher surgical trainees. Analysis of the electronic logbooks over a 5-year period reveals the high volume of procedures available to trainees in a non-specialist centre. Such training opportunities are invaluable in the context of changing work practices and limited resources.

  1. Engagement and role of surgical trainees in global surgery: Consensus statement and recommendations from the Association of Surgeons in Training.

    Science.gov (United States)

    Mohan, Helen M; Fitzgerald, Edward; Gokani, Vimal; Sutton, Paul; Harries, Rhiannon; Bethune, Robert; McDermott, Frank D

    2018-04-01

    to trainees considering a global surgery placement include approval for placements while on a training program, financial cost and dangers inherent in working in a resource poor setting. Currently global surgery experience is generally as an out of program experience and does not count for certificate of completion of training (CCT). Methods to recognise surgical trainee global surgery experience as an integrated part of training should be explored, similar to that seen in other specialties. There is a role for surgical trainees to become involved in Global Surgery, especially in partnership with local surgeons and with appropriate ethical consideration. Trainees develop translational skills in resource poor settings. Development of appropriate pathways for recognition of global surgery experience for CCT should be considered. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  2. 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.

  3. 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

  4. 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.

  5. 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

  6. 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.

  7. 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.

  8. 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.

  9. Identifying gaps in the surgical training curriculum in Rwanda through evaluation of operative activity at a teaching hospital.

    Science.gov (United States)

    Rickard, Jennifer L; Ntakiyiruta, Georges; Chu, Kathryn M

    2015-01-01

    To define the operations performed by surgical residents at a tertiary referral hospital in Rwanda to help guide development of the residency program. Cross-sectional study of all patients operated by surgical residents from October 2012 to September 2013. University Teaching Hospital of Kigali (Centre Hospitalier Universitaire de Kigali [CHUK]), a public, tertiary referral hospital in Kigali, Rwanda. All patient data were entered into the operative database by surgical residents at CHUK. A total of 2833 cases were entered into the surgical database. Of them, 53 cases were excluded from further analysis because no surgical resident was listed as the primary or assistant surgeon, leaving 2780 cases for analysis. There were 2780 operations involving surgical residents. Of them, 51% of procedures were classified under general surgery, 38% orthopedics, 7% neurosurgery, and 4% urology. Emergency operations accounted for 64% of the procedures, with 56% of those being general surgery and 35% orthopedic. Further, 50% of all operations were trauma, with 71% of those orthopedic and 21% general surgery. Surgical faculty were involved in 45% of operations as either the primary or the assistant surgeons, while the remainder of operations did not involve surgical faculty. Residents were primary surgeons in 68% of procedures and assistant surgeons in 84% of procedures. The operative experience of surgery residents at CHUK primarily involves emergency and trauma procedures. Although this likely reflects the demographics of surgical care within Rwanda, more focus should be placed on elective procedures to ensure that surgical residents are broadly trained. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  10. 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.

  11. Implementation of a Cross-specialty Training Program in Basic Laparoscopy

    DEFF Research Database (Denmark)

    Bjerrum, Flemming; Sorensen, Jette Led; Thinggaard, Jette

    2015-01-01

    BACKGROUND AND OBJECTIVES: Several surgical specialties use laparoscopy and share many of the same techniques and challenges, such as entry approaches, equipment, and complications. However, most basic training programs focus on a single specialty. The objective of this study was to describe the ...... laparoscopy is feasible. There are several logistic benefits of using a cross-specialty approach; however, it is important that local departments include specialty-specific components, together with clinical departmental follow-up....

  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. New technologies and surgical innovation: five years of a local health technology assessment program in a surgical department.

    Science.gov (United States)

    Poulin, Paule; Austen, Lea; Kortbeek, John B; Lafrenière, René

    2012-06-01

    There is pressure for surgical departments to introduce new and innovative health technologies in an evidence-based manner while ensuring that they are safe and effective and can be managed with available resources. A local health technology assessment (HTA) program was developed to systematically integrate research evidence with local operational management information and to make recommendations for subsequent decision by the departmental executive committee about whether and under what conditions the technology will be used. The authors present a retrospective analysis of the outcomes of this program as used by the Department of Surgery & Surgical Services in the Calgary Health Region over a 5-year period from December 2005 to December 2010. Of the 68 technologies requested, 15 applications were incomplete and dropped, 12 were approved, 3 were approved for a single case on an urgent/emergent basis, 21 were approved for "clinical audit" for a restricted number of cases with outcomes review, 14 were approved for research use only, and 3 were referred to additional review bodies. Subsequent outcome reports resulted in at least 5 technologies being dropped for failure to perform. Decisions based on local HTA program recommendations were rarely "yes" or "no." Rather, many technologies were given restricted approval with full approval contingent on satisfying certain conditions such as clinical outcomes review, training protocol development, or funding. Thus, innovation could be supported while ensuring safety and effectiveness. This local HTA program can be adapted to a variety of settings and can help bridge the gap between evidence and practice.

  14. 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.

  15. TAP 1, Training Program Manual

    International Nuclear Information System (INIS)

    1991-01-01

    Training programs at DOE nuclear facilities should provide well-trained, qualified personnel to safely and efficiently operate the facilities in accordance with DOE requirements. A need has been identified for guidance regarding analysis, design, development, implementation, and evaluation of consistent and reliable performance-based training programs. Accreditation of training programs at Category A reactors and high-hazard and selected moderate-hazard nonreactor nuclear facilities will assure consistent, appropriate, and cost-effective training of personnel responsible for the operation, maintenance, and technical support of these facilities. Training programs that are designed and based on systematically determined job requirements, instead of subjective estimation of trainee needs, yield training activities that are consistent and develop or improve knowledge, skills, and abilities that can be directly related to the work setting. Because the training is job-related, the content of these programs more efficiently meets the needs of the employee. Besides a better trained work force, a greater level of operational reactor safety can be realized. This manual is intended to provide an overview of the accreditation process and a brief description of the elements necessary to construct and maintain training programs that are based on the requirements of the job. Two companion manuals provide additional information to assist contractors in their efforts to accredit training programs

  16. 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

    participants independent of their levels of experience which could be an important key for streamlining the learning curve. Future studies testing the predictive validation of the simulator and frequency of the training intervals are necessary before the introduction of the simulator into the standard surgical training curriculum. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  17. Cluster randomized trial to evaluate the impact of team training on surgical outcomes.

    Science.gov (United States)

    Duclos, A; Peix, J L; Piriou, V; Occelli, P; Denis, A; Bourdy, S; Carty, M J; Gawande, A A; Debouck, F; Vacca, C; Lifante, J C; Colin, C

    2016-12-01

    The application of safety principles from the aviation industry to the operating room has offered hope in reducing surgical complications. This study aimed to assess the impact on major surgical complications of adding an aviation-based team training programme after checklist implementation. A prospective parallel-group cluster trial was undertaken between September 2011 and March 2013. Operating room teams from 31 hospitals were assigned randomly to participate in a team training programme focused on major concepts of crew resource management and checklist utilization. The primary outcome measure was the occurrence of any major adverse event, including death, during the hospital stay within the first 30 days after surgery. Using a difference-in-difference approach, the ratio of the odds ratios (ROR) was estimated to compare changes in surgical outcomes between intervention and control hospitals. Some 22 779 patients were enrolled, including 5934 before and 16 845 after team training implementation. The risk of major adverse events fell from 8·8 to 5·5 per cent in 16 intervention hospitals (adjusted odds ratio 0·57, 95 per cent c.i. 0·48 to 0·68; P trends revealed significant improvements among ten institutions, equally distributed across intervention and control hospitals. Surgical outcomes improved substantially, with no difference between trial arms. Successful implementation of an aviation-based team training programme appears to require modification and adaptation of its principles in the context of the the surgical milieu. Registration number: NCT01384474 (http://www.clinicaltrials.gov). © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

  18. 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.

  19. 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.

  20. Postoperative pneumonia-prevention program for the inpatient surgical ward.

    Science.gov (United States)

    Wren, Sherry M; Martin, Molinda; Yoon, Jung K; Bech, Fritz

    2010-04-01

    Postoperative pneumonia can lead to increased morbidity, length of hospital stay, and costs. Pneumonia-prevention programs have been successfully implemented in ICU settings, but no program exists for surgical ward patients. A pilot prevention program was designed and implemented based on literature review. The program consisted of education of physicians and ward staff and a standardized postoperative electronic order set consisting of incentive spirometer, chlorhexidine oral hygiene, ambulation, and head-of-bed elevation. Quarterly staff meetings discussed the results of and compliance with the program. The intervention commenced in April 2007. Baseline incidence of inpatient ward pneumonia was calculated from the National Surgical Quality Improvement Program database for fiscal year (FY) 2006 and FY 2007. Postintervention incidence was calculated in the same manner from FY 2007 through FY 2008. Any patient who contracted pneumonia in the ICU was excluded from analysis. There was a significant decrease in ward pneumonia incidence from 0.78% in the preintervention group compared with 0.18% in the postintervention group (p = 0.006), representing an 81% decrease in incidence from 2006 to 2008. The pneumonia-prevention program was very successful in diminishing postoperative pneumonia on the surgical ward. There was a highly statistically significant 4-fold decrease in pneumonia incidence after program implementation. The interventions were not costly but did require ongoing communication and cooperation between physician and nursing leadership to achieve compliance with the measures. This program has great potential for dissemination to hospital surgical wards and could decrease inpatient postoperative pneumonias. Published by Elsevier Inc.

  1. 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.

  2. History and future of human cadaver preservation for surgical training: from formalin to saturated salt solution method.

    Science.gov (United States)

    Hayashi, Shogo; Naito, Munekazu; Kawata, Shinichi; Qu, Ning; Hatayama, Naoyuki; Hirai, Shuichi; Itoh, Masahiro

    2016-01-01

    Traditionally, surgical training meant on-the-job training with live patients in an operating room. However, due to advancing surgical techniques, such as minimally invasive surgery, and increasing safety demands during procedures, human cadavers have been used for surgical training. When considering the use of human cadavers for surgical training, one of the most important factors is their preservation. In this review, we summarize four preservation methods: fresh-frozen cadaver, formalin, Thiel's, and saturated salt solution methods. Fresh-frozen cadaver is currently the model that is closest to reality, but it also presents myriad problems, including the requirement of freezers for storage, limited work time because of rapid putrefaction, and risk of infection. Formalin is still used ubiquitously due to its low cost and wide availability, but it is not ideal because formaldehyde has an adverse health effect and formalin-embalmed cadavers do not exhibit many of the qualities of living organs. Thiel's method results in soft and flexible cadavers with almost natural colors, and Thiel-embalmed cadavers have been appraised widely in various medical disciplines. However, Thiel's method is relatively expensive and technically complicated. In addition, Thiel-embalmed cadavers have a limited dissection time. The saturated salt solution method is simple, carries a low risk of infection, and is relatively low cost. Although more research is needed, this method seems to be sufficiently useful for surgical training and has noteworthy features that expand the capability of clinical training. The saturated salt solution method will contribute to a wider use of cadavers for surgical training.

  3. Development of a PROficiency-Based StePwise Endovascular Curricular Training (PROSPECT) Program.

    Science.gov (United States)

    Maertens, Heidi; Aggarwal, Rajesh; Desender, Liesbeth; Vermassen, Frank; Van Herzeele, Isabelle

    2016-01-01

    Focus on patient safety, work-hour limitations, and cost-effective education is putting pressure to improve curricula to acquire minimally invasive techniques during surgical training. This study aimed to design a structured training program for endovascular skills and validate its assessment methods. A PROficiency-based StePwise Endovascular Curricular Training (PROSPECT) program was developed, consisting of e-learning and hands-on simulation modules, focusing on iliac and superficial femoral artery atherosclerotic disease. Construct validity was investigated. Performances were assessed using multiple-choice questionnaires, valid simulation parameters, global rating scorings, and examiner checklists. Feasibility was assessed by passage of 2 final-year medical students through this PROSPECT program. Ghent University Hospital, a tertiary clinical care and academic center in Belgium with general surgery residency program. Senior-year medical students were recruited at Ghent University Hospital. Vascular surgeons were invited to participate during conferences and meetings if they had performed at least 100 endovascular procedures as the primary operator during the last 2 years. Overall, 29 medical students and 20 vascular surgeons participated. Vascular surgeons obtained higher multiple-choice questionnaire scores (median: 24.5-22.0 vs. 15.0-12.0; p train cognitive, technical, and nontechnical endovascular skills was developed. A structured, stepwise, proficiency-based valid endovascular program to train cognitive, technical, and human factor skills has been developed and proven to be feasible. A randomized controlled trial has been initiated to investigate its effect on performances in real life, patient outcomes, and cost-effectiveness. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  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. 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.

  6. 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.

  7. Impact of the Surgical Research Methodology Program on surgical residents' research profiles.

    Science.gov (United States)

    Farrokhyar, Forough; Amin, Nalin; Dath, Deepak; Bhandari, Mohit; Kelly, Stephan; Kolkin, Ann M; Gill-Pottruff, Catherine; Skot, Martina; Reid, Susan

    2014-01-01

    To evaluate whether implementing the formal Surgical Research Methodology (SRM) Program in the surgical residency curriculum improved research productivity compared with the preceding informal Research Seminar Series (RSS). The SRM Program replaced the RSS in July 2009. In the SRM Program, the curriculum in Year-1 consisted of 12 teaching sessions on the principles of clinical epidemiology and biostatistics, whereas the focus in Year-2 was on the design, conduct, and presentation of a research project. The RSS consisted of 8 research methodology sessions repeated annually for 2 years along with the design, conduct, and presentation of a research project. Research productivity was measured as the number of peer-reviewed publications and the generation of studies with higher levels of evidence. Outcome measures were independently assessed by 2 authors to avoid bias. Student t test and chi-square test were used for the analysis. Frequencies, mean differences with 95% CI, and effect sizes have been reported. In this study, 81 SRM residents were compared with 126 RSS residents. The performance of the SRM residents was superior on all metrics in our evaluation. They were significantly more productive and published more articles than the RSS residents (mean difference = 1.0 [95% CI: 0.5-1.5], p research performance improved 11.0 grades (95% CI: 8.5%-13.5%, p research methodology is crucial to appropriately apply evidence-based findings in clinical practice. The SRM Program has significantly improved the research productivity and performance of the surgical residents from all disciplines. The implementation of a similar research methodology program is highly recommended for the benefit of residents' future careers and ultimately, evidence-based patient care. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  8. Developing a successful robotics program.

    Science.gov (United States)

    Luthringer, Tyler; Aleksic, Ilija; Caire, Arthur; Albala, David M

    2012-01-01

    Advancements in the robotic surgical technology have revolutionized the standard of care for many surgical procedures. The purpose of this review is to evaluate the important considerations in developing a new robotics program at a given healthcare institution. Patients' interest in robotic-assisted surgery has and continues to grow because of improved outcomes and decreased periods of hospitalization. Resulting market forces have created a solid foundation for the implementation of robotic surgery into surgical practice. Given proper surgeon experience and an efficient system, robotic-assisted procedures have been cost comparable to open surgical alternatives. Surgeon training and experience is closely linked to the efficiency of a new robotics program. Formally trained robotic surgeons have better patient outcomes and shorter operative times. Training in robotics has shown no negative impact on patient outcomes or mentor learning curves. Individual economic factors of local healthcare settings must be evaluated when planning for a new robotics program. The high cost of the robotic surgical platform is best offset with a large surgical volume. A mature, experienced surgeon is integral to the success of a new robotics program.

  9. Personal satisfaction and mentorship are critical factors for today's resident surgeons to seek surgical training.

    Science.gov (United States)

    Lukish, Jeffrey; Cruess, David

    2005-11-01

    The specific aim of this study was to summarize the viewpoints of the Resident and Associate Society of the American College of Surgeons (RAS-ACS) membership regarding current training and quality of life-related issues prior to implementation of the new duty-hour guidelines. The goal was to gain insight of the members that may be useful to recruit and guide the future training of surgical residents. An Internet-based survey was developed to evaluate the viewpoints of RAS-ACS. The survey was administered by Esurveymaker.com via the ACS Web page from 2000 to 2003. RAS-ACS member participation was voluntary and anonymous. Analyses were performed to determine the frequency of response for each survey item. Two hundred thirty-five members completed the survey representing 5 per cent of RAS-ACS. Eighty-four per cent were general surgery residents. Personal satisfaction (64%) and mentorship (49%) were top factors for respondents to pursue surgical training; discussion with colleagues and future income was less important. Forty-five per cent reported that job performance was their most important concern during residency. A rewarding surgical career and family life were ranked as the most important expectations. Eighty-six per cent reported that they were satisfied with their residency, and 66 per cent reported that work hours should be limited. Personal satisfaction and mentorship were critical factors for members of the RAS-ACS to seek surgical training. Although most of the members report that work hours should be limited, an overwhelming majority reports satisfaction with surgical training prior to institution of the new duty-hour guidelines. Further emphasis on mentorship and work-hour reform may be beneficial in recruiting medical students into surgical residencies.

  10. Open surgical simulation--a review.

    Science.gov (United States)

    Davies, Jennifer; Khatib, Manaf; Bello, Fernando

    2013-01-01

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

  11. Surgical training and the European Working Time Directive: The role of informal workplace learning.

    Science.gov (United States)

    Giles, James A

    2010-01-01

    The introduction of European Working Time Directive, limiting doctors' working hours to 48 per week, has caused recent controversy within the profession. The Royal College of Surgeons of England in particular has been one of the loudest critics of the legislation. One of the main concerns is regarding the negative impact on training hours for those embarking on surgical careers. Simulation technology has been suggested as a method to overcome this reduction in hospital training hours, and research suggests that this is a good substitute for operative training in a theatre. However, modern educational theory emphasises the power of informal workplace learning in postgraduate education, and the essential role of experience in training future surgeons. Copyright 2010 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  12. For Love, Not Money: The Financial Implications of Surgical Fellowship Training.

    Science.gov (United States)

    Inclan, Paul M; Hyde, Adam S; Hulme, Michael; Carter, Jeffrey E

    2016-09-01

    Surgical residents cite increased income potential as a motivation for pursuing fellowship training, despite little evidence supporting this perception. Thus, our goal is to quantify the financial impact of surgical fellowship training on financial career value. By using Medical Group Management Association and Association of American Medical Colleges physician income data, and accounting for resident salary, student debt, a progressive tax structure, and forgone wages associated with prolonged training, we generated a net present value (NPV) for both generalist and subspecialist surgeons. By comparing generalist and subspecialist career values, we determined that cardiovascular (NPV = 698,931), pediatric (430,964), thoracic (239,189), bariatric (166,493), vascular (96,071), and transplant (46,669) fellowships improve career value. Alternatively, trauma (11,374), colorectal (44,622), surgical oncology (203,021), and breast surgery (326,465) fellowships all reduce career value. In orthopedic surgery, spine (505,198), trauma (123,250), hip and joint (60,372), and sport medicine (56,167) fellowships improve career value, whereas shoulder and elbow (4,539), foot and ankle (173,766), hand (366,300), and pediatric (489,683) fellowships reduce career NPV. In obstetrics and gynecology, reproductive endocrinology (352,854), and maternal and fetal medicine (322,511) fellowships improve career value, whereas gynecology oncology (28,101) and urogynecology (206,171) fellowships reduce career value. These data indicate that the financial return of fellowship is highly variable.

  13. Privacy Training Program

    Science.gov (United States)

    Recognizing that training and awareness are critical to protecting agency Personally Identifiable Information (PII), the EPA is developing online training for privacy contacts in its programs and regions.

  14. Consistency of performance of robot-assisted surgical tasks in virtual reality.

    Science.gov (United States)

    Suh, I H; Siu, K-C; Mukherjee, M; Monk, E; Oleynikov, D; Stergiou, N

    2009-01-01

    The purpose of this study was to investigate consistency of performance of robot-assisted surgical tasks in a virtual reality environment. Eight subjects performed two surgical tasks, bimanual carrying and needle passing, with both the da Vinci surgical robot and a virtual reality equivalent environment. Nonlinear analysis was utilized to evaluate consistency of performance by calculating the regularity and the amount of divergence in the movement trajectories of the surgical instrument tips. Our results revealed that movement patterns for both training tasks were statistically similar between the two environments. Consistency of performance as measured by nonlinear analysis could be an appropriate methodology to evaluate the complexity of the training tasks between actual and virtual environments and assist in developing better surgical training programs.

  15. NTC operator training program viewed from SAT-based training process

    International Nuclear Information System (INIS)

    Matsumoto, Yoshio

    1996-01-01

    The Nuclear Power Training Center Ltd. (NTC) was established in June 1972 to train PWR plant operators. Operator training was started in Apr. 1974. Presently we have three full-scope, control-room simulators. Recently IAEA recommended that its Systematic Approach to Training (SAT) be used for the training of NPP personnel. We thoroughly examined the SAT-based process and compared it against the NTC training program. As a result, we have recognized that the NTC training program satisfies the SAT-based training process. We now intend to improve the feedback step of the NTC training system. Our efforts continue to produce a relevant program at the forefront of our profession. (author)

  16. Training together: how another human's presence affects behavior during virtual human-based team training

    Directory of Open Access Journals (Sweden)

    Andrew Robb

    2016-08-01

    Full Text Available Despite research showing that team training can lead to strong improvements in team performance, logistical difficulties can prevent team training programs from being adopted on a large scale. A proposed solution to these difficulties is the use of virtual humans to replace missing teammates. Existing research evaluating the use of virtual humans for team training has been conducted in settings involving a single human trainee. However, in the real world multiple human trainees would most likely train together. In this paper, we explore how the presence of a second human trainee can alter behavior during a medical team training program. Ninety-two nurses and surgical technicians participated in a medical training exercise, where they worked with a virtual surgeon and virtual anesthesiologist to prepare a simulated patient for surgery. The agency of the nurse and the surgical technician were varied between three conditions: human nurses and surgical technicians working together; human nurses working with a virtual surgical technician; and human surgical technicians working with a virtual nurse. Variations in agency did not produce statistically significant differences in the training outcomes, but several notable differences were observed in other aspects of the team's behavior. Specifically, when working with a virtual nurse, human surgical technicians were more likely to assist with speaking up about patient safety issues that were outside of their normal responsibilities; human trainees spent less time searching for a missing item when working with a virtual partner, likely because the virtual partner was physically unable to move throughout the room and assist with the searching process; and more breaks in presence were observed when two human teammates were present. These results show that some behaviors may be influenced by the presence of multiple human trainees, though these behaviors may not impinge on core training goals. When

  17. The efficacy of stuttering measurement training: evaluating two training programs.

    Science.gov (United States)

    Bainbridge, Lauren A; Stavros, Candace; Ebrahimian, Mineh; Wang, Yuedong; Ingham, Roger J

    2015-04-01

    Two stuttering measurement training programs currently used for training clinicians were evaluated for their efficacy in improving the accuracy of total stuttering event counting. Four groups, each with 12 randomly allocated participants, completed a pretest-posttest design training study. They were evaluated by their counts of stuttering events on eight 3-min audiovisual speech samples from adults and children who stutter. Stuttering judgment training involved use of either the Stuttering Measurement System (SMS), Stuttering Measurement Assessment and Training (SMAAT) programs, or no training. To test for the reliability of any training effect, SMS training was repeated with the 4th group. Both SMS-trained groups produced approximately 34% improvement, significantly better than no training or the SMAAT program. The SMAAT program produced a mixed result. The SMS program was shown to produce a "medium" effect size improvement in the accuracy of stuttering event counts, and this improvement was almost perfectly replicated in a 2nd group. Half of the SMAAT judges produced a 36% improvement in accuracy, but the other half showed no improvement. Additional studies are needed to demonstrate the durability of the reported improvements, but these positive effects justify the importance of stuttering measurement training.

  18. TAP 3, Training Program Support Manual

    International Nuclear Information System (INIS)

    1991-07-01

    Training programs at DOE facilities should provide well-trained, qualified personnel to safely and efficiently operate the facilities in accordance with DOE requirements. A need has been identified for guidance regarding analysis, design, development, implementation, and evaluation of consistent and reliable performance-based training programs. Accreditation of training programs at Category A reactors and high-hazard and selected moderate-hazard nonreactor nuclear facilities will assure consistent, appropriate, and cost-effective training of personnel responsible for the operation, maintenance, and technical support of these facilities. Training programs that are designed and based on systematically determined job requirements, instead of subjective estimation of trainee needs, yield training activities that are consistent and develop or improve knowledge, skills, and abilities that can be directly related to the work setting. Because the training is job-related, the content of these programs more efficiently and effectively meets the needs of the employee. Besides a better trained work force, a greater level of operational reactor safety can be realized. This manual is intended to provide an overview of the accreditation process and a brief description of the elements necessary to construct and maintain training programs that are based on the requirements of the job. Two companion manuals provide additional information to assist contractors in their efforts to accredit training programs

  19. Integrated surgical emergency training plan in the internship: A step toward improving the quality of training and emergency center management.

    Science.gov (United States)

    Akhlaghi, Mohammad Reza; Vafamehr, Vajiheh; Dadgostarnia, Mohammad; Dehghani, Alireza

    2013-01-01

    In this study, by using a problem-oriented approach in the needs assessment, identifying the defects and deficiencies in emergency health training centers has been determined as the basis for the requirements. The main objective of the study was the implementation of surgical emergencies integration of the five surgical groups (general surgery, urology, orthopedics, neurosurgery, and ENT) to meet the needs and determining its efficacy. THIS INTERVENTIONAL STUDY WAS CONDUCTED IN THREE PHASES: (1) Phase I (design and planning): Needs assessment, recognition of implementation barriers and providing the objectives and training program for integrated emergencies. (2) Phase II (implementation): Justification of the main stakeholders of the project, preparation of students' duties in the emergency department, preparation of on-duty plans, supervising the implementation of the program, and reviewing the plan in parallel with the implementation based on the problems. (3) Phase III (evaluation): Reviewing the evidences based on the amount of efficiency of the plan and justification for its continuation. In the first and the second phase, the data were collected through holding focus group meetings and interviews. In the third phase, the opened-reply and closed-reply researcher-made questionnaires were used. The questionnaire face and content validity were confirmed by experts and the reliability was assessed by calculating the Cronbach's alpha. ACCORDING TO THE VIEWS OF THE INTERNS, ASSISTANTS, TEACHERS, AND EMERGENCY PERSONNEL, THE POSITIVE FEATURES OF THE PLAN INCLUDED THE FOLLOWING: Increasing the patients' satisfaction, reducing the patients' stay in the Emergency Department, increasing the speed of handling the patients, balancing the workloads of the interns, direct training of interns by young teachers of emergency medicine, giving the direct responsibility of the patient to the intern, practical and operational training of emergency issues, increasing the teamwork

  20. Training Accreditation Program

    International Nuclear Information System (INIS)

    1989-01-01

    The cornerstone of safe operation of Department of Energy (DOE) nuclear facilities is personnel performing the day-to-day functions which accomplish the facility mission. Training that is conducted efficiently and effectively and is directly related to the needs of the job (i.e. performance-based training) is fundamental to safe operation. Responsibility for the safe operation of these facilities is a line management function. Therefore, achieving performance-based training requires commitment from the organization for which training is provided. This commitment includes making subject matter experts available for participation in and review of the products of the performance-based training process. It also includes budgeting and scheduling the time required for both initial and continuing training. This commitment must be made by corporate and facility senior management from the beginning. Management must get involved at the start to ensure that they are not only cognizant of ongoing activities, but are also involved to the degree necessary to thoroughly understand the process. Policies implemented and support demonstrated by senior management provide the driving force to ensure that training programs receive the attention that is imperative if facility training programs are to be successful

  1. Perceptions of gender-based discrimination during surgical training and practice.

    Science.gov (United States)

    Bruce, Adrienne N; Battista, Alexis; Plankey, Michael W; Johnson, Lynt B; Marshall, M Blair

    2015-01-01

    Women represent 15% of practicing general surgeons. Gender-based discrimination has been implicated as discouraging women from surgery. We sought to determine women's perceptions of gender-based discrimination in the surgical training and working environment. Following IRB approval, we fielded a pilot survey measuring perceptions and impact of gender-based discrimination in medical school, residency training, and surgical practice. It was sent electronically to 1,065 individual members of the Association of Women Surgeons. We received 334 responses from medical students, residents, and practicing physicians with a response rate of 31%. Eighty-seven percent experienced gender-based discrimination in medical school, 88% in residency, and 91% in practice. Perceived sources of gender-based discrimination included superiors, physician peers, clinical support staff, and patients, with 40% emanating from women and 60% from men. The majority of responses indicated perceived gender-based discrimination during medical school, residency, and practice. Gender-based discrimination comes from both sexes and has a significant impact on women surgeons.

  2. An introduction to electronic learning and its use to address challenges in surgical training.

    Science.gov (United States)

    Baran, Szczepan W; Johnson, Elizabeth J; Kehler, James

    2009-06-01

    The animal research community faces a shortage of surgical training opportunities along with an increasing demand for expertise in surgical techniques. One possible means of overcoming this challenge is the use of computer-based or electronic learning (e-learning) to disseminate material to a broad range of animal users. E-learning platforms can take many different forms, ranging from simple text documents that are posted online to complex virtual courses that incorporate dynamic video or audio content and in which students and instructors can interact in real time. The authors present an overview of e-learning and discuss its potential benefits as a supplement to hands-on rodent surgical training. They also discuss a few basic considerations in developing and implementing electronic courses.

  3. Trends in Surgical Practices for Lateral Epicondylitis Among Newly Trained Orthopaedic Surgeons.

    Science.gov (United States)

    Wang, Dean; Degen, Ryan M; Camp, Christopher L; McGraw, Michael H; Altchek, David W; Dines, Joshua S

    2017-10-01

    Much controversy exists regarding the optimal surgical intervention for lateral epicondylitis because of a multitude of options available and the lack of comparative studies. Knowledge of the current practice trends would help guide the design of comparative studies needed to determine which surgical technique results in the best outcome. To review the latest practice trends for the surgical treatment of lateral epicondylitis among newly trained surgeons in the United States utilizing the American Board of Orthopaedic Surgery (ABOS) database. Cross-sectional study; Level of evidence, 3. The ABOS database was utilized to identify surgical cases for lateral epicondylitis submitted by Part II board certification examination candidates from 2004 through 2013. Inclusion criteria were predetermined using a combination of International Classification of Diseases, Ninth Revision (ICD-9) and Current Procedural Terminology (CPT) codes. Cases were organized by open and arthroscopic treatment groups and by fellowship training and were analyzed to determine differences in surgical techniques, complication rates, and concomitant procedures. In total, 1150 surgeons submitted 2106 surgical cases for the treatment of lateral epicondylitis. The number of surgical cases for lateral epicondylitis performed per 10,000 submitted cases significantly decreased from 26.7 in 2004 to 21.1 in 2013 ( P = .002). Among all cases, 92.2% were open and 7.8% were arthroscopic, with no change in the incidence of arthroscopic surgeries over the study period. Shoulder and elbow (18.1%) and sports medicine (11.4%) surgeons were more likely to perform surgery arthroscopically compared with hand surgeons (6.1%) ( P < .001). There was no difference in overall self-reported complication rates between open (4.4%) and arthroscopic (5.5%) procedures ( P = .666). Percutaneous tenotomy, debridement only, and debridement with tendon repair comprised 6.4%, 46.3%, and 47.3% of open treatment, respectively. Sports

  4. Surgical competence.

    Science.gov (United States)

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

    2003-08-01

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

  5. Training programming: revisiting terminology

    Directory of Open Access Journals (Sweden)

    Mário C. Marques

    2017-11-01

    Full Text Available Does the way the literature presents the classic periodization or programming make sense? In our opinion, the answer is clearly no. To get started, periodization and programming are terms used interchangeably (as synonyms in scientific literature when they actually have different meanings. Thus, to periodize is to set periods for a process (e.g., to a season or the sports life, whereas programming is defined as to devise and order the necessary actions to carry out a project. Accordingly, coaches and physical conditioning professionals should divide or periodize the season in different cycles and then, within each cycle, programming the training sessions. The periodization should not only help to structure the training process, but also to express the goals to achieve, to control the training process evolution and allow a great execution of the action plan. When designing a plan, we simply organize all the “ingredients” that should be part of the work/training design in a concrete and detailed way. From a scientific point of view, the programming is nothing more than an adequate interpretation of the training biological laws (Tschione, 1992; Latonov, 1997, Issurin, 2008 and must have the performance improvement as the major reference criteria (Issurin 2010. In practice, during the last decades, we have followed a set of instructions mainly based on experienced coaches (Matveyev, 1981, Bompa, 1994, Zatsiorsky, 1995 who have obtained relevant results. As a consequence, it is very difficult to accept another solid scientific based vision or proposal since the accumulation of systematic experiences has led to the construction of a theoretical model, even though there are no scientific evidences. The multiplication and implementation of the traditional programming models (Matveyev, 1981, Bompa, 1994 have guided us to a set of erroneous terms, among which we highlight the “micro”, the “meso” and the “macro” cycles, that were never

  6. The Interventional Arm of the Flexibility In Duty-Hour Requirements for Surgical Trainees Trial: First-Year Data Show Superior Quality In-Training Initiative Outcomes.

    Science.gov (United States)

    Mirmehdi, Issa; O'Neal, Cindy-Marie; Moon, Davis; MacNew, Heather; Senkowski, Christopher

    With the implementation of strict 80-hour work week in general surgery training, serious questions have been raised concerning the quality of surgical education and the ability of newly trained general surgeons to independently operate. Programs that were randomized to the interventional arm of the Flexibility In duty-hour Requirements for Surgical Trainees (FIRST) Trial were able to decrease transitions and allow for better continuity by virtue of less constraints on duty-hour rules. Using National Surgical Quality Improvement Program Quality In-Training Initiative data along with duty-hour violations compared with old rules, it was hypothesized that quality of care would be improved and outcomes would be equivalent or better than the traditional duty-hour rules. It was also hypothesized that resident perception of compliance with duty hour would not change with implementation of new regulations based on FIRST trial. Flexible work hours were implemented on July 1, 2014. National Surgical Quality Improvement Program Quality In-Training Initiative information was reviewed from July 2014 to January 2015. Patient risk factors and outcomes were compared between institutional resident cases and the national cohort for comparison. Residents' duty-hour logs and violations during this period were compared to the 6-month period before the implementation of the FIRST trial. The annual Accreditation Council for Graduate Medical Education resident survey was used to assess the residents' perception of compliance with duty hours. With respect to the postoperative complications, the only statistically significant measures were higher prevalence of pneumonia (3.4% vs. 1.5%, p flexible duty hours. All other measures of postoperative surgical complications showed no difference. The total number of duty-hour violations decreased from 54 to 16. Had the institution not been part of the interventional arm of the FIRST trial, this number would have increased to 238. The residents

  7. 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.

  8. 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

  9. Implementation of a novel portfolio of structured, curriculum-aligned, simulation-based, cardiothoracic surgery training courses: Evolving the delivery of surgical education.

    Science.gov (United States)

    Moorjani, Narain; Lewis, Michael; Shah, Rajesh; Barnard, Sion; Graham, Tim; Rathinam, Sridhar

    2017-12-01

    The provision of high-quality cardiothoracic surgical training faces many challenges. This has generated an increased interest in simulation-based learning, which can provide a less stressful environment for deliberate practice. We developed a comprehensive, structured program of knowledge and simulation-based learning aligned to the official cardiothoracic surgery curriculum. A portfolio of 10 curriculum-aligned training courses was designed for cardiothoracic surgical trainees during their 6-year training program. The courses were delivered through a multitude of education methods, including live porcine operating simulation models, and were evaluated through a series of quantitative (5-point Likert-scale) and qualitative assessments. The trainees (n = 15-21 per course) also completed pre- and postsession self-confidence and competency levels for each training episode of knowledge and skill, respectively. In addition, board examination pass rates were assessed in the 3-year periods before and after implementation of the courses. Quantitative analysis of the trainees' feedback demonstrated an extremely positive view of the portfolio of the simulation-based training courses with excellent satisfaction scores (out of 5) for teaching sessions (4.44 ± 0.07), faculty (4.64 ± 0.07), content and materials (4.63 ± 0.07), and facilities (4.73 ± 0.05). The courses have shown a significant improvement in the post-self-confidence (7.98 ± 0.13 vs 5.62 ± 0.20, P < .01) and perceived self-competency (8.10 ± 0.10 vs 5.67 ± 0.11, P < .01) scores for all courses. Examination pass rates significantly improved in the 3-year period after attendance at the courses (94.82% ± 2.34% vs 76.26% ± 3.23%, P < .005). This study has described the implementation of the only extensive program of structured simulation-based courses that has been developed to complement clinical training in cardiothoracic surgery. Crown Copyright © 2017. Published by Elsevier

  10. Development of a training assurance program

    International Nuclear Information System (INIS)

    Palchinsky, J.; Waylett, W.J. Jr.

    1987-01-01

    The nuclear industry has made a significant commitment to improve training through the implementation of accredited performance-based training programs. Senior management expects that human performance will improve as a result of significant resource allocations. How do they know if training is effective in achieving improved human performance? Florida Power and Light Company is developing a Training Assurance Program to track indicators of training performance and future trends. Integrating the company's Quality Improvement Program processes with systematic training processes is resulting in personnel functioning in a proactive mode and increased customer satisfaction with training performance

  11. 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...

  12. Strategies to accommodate resident work-hour restrictions: impact on surgical education.

    Science.gov (United States)

    Freiburg, Carter; James, Ted; Ashikaga, Takamura; Moalem, Jacob; Cherr, Greg

    2011-01-01

    The introduction of duty-hour restrictions has impacted surgical training. Several strategies were introduced by training programs in response to these restrictions. The purpose of this study was to assess the various strategies employed by residency programs to comply with work-hour restrictions with respect to the impact on the quality of surgical education. A national survey was developed and distributed to resident members of the Resident and Associate Society of the American College of Surgeons in all accredited residency programs across North America. Questions in the survey addressed 10 separate accommodation strategies used by training programs to adhere to resident work-hour restrictions. Resident respondents completed a 5-point Likert scale rating each strategy according to its impact on surgical education (detrimental, not very helpful, neutral, somewhat helpful, and very helpful). A total of 599 (9.7%) responses were received from 6186 members of the Resident Associate Society. The use of health information technology (IT), nurse practitioners, and physician assistants were most highly rated. Hiring clinical fellows, establishing nonteaching services, and shift-work scheduling were the three most poorly rated accommodations to work-hour restrictions with respect to resident education. Hospital IT and nonphysician care providers were rated by residents to optimize surgical education in the current work-hour limitation environment. We infer that strategies which lead to increased efficiency and redistribution of resident workload allow surgical trainees to spend more time on activities perceived to have higher educational value. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  13. 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...

  14. The application and interviewing process for surgical house officership.

    Science.gov (United States)

    Rutkow, I M; Imbembo, A L; Zuidema, G D

    1979-02-01

    The application and interviewing procedure for surgical house officership is an important process to both the medical student and the clinical department. Up-to-date, informative, and honest appraisals of the training programs under evaluation must be obtained. A survey was undertaken to compare and contrast students' and surgical department members' perceptions of nationwide surgical residency application procedures. It is concluded from this sampling that the majority of medical students applying to university-sponsored surgical training programs and the training institutions themselves generally are satisfied with the present application and interviewing experience. Certain areas in need of reform were elucidated, and the following recommendations are offered to aid in the development of a more effective process: (1) if possible, the descriptive information brochure should be updated on a yearly basis and must be comprehensive in scope; (2) when "en masse" interviewing is conducted, it should be held on a number of dates during the year, not just one, and a limited time for "walk-in" interviews should be allowed; (3) an opportunity should be available for the spouse or fiance'(e) to accompany the applicant; (4) an interviewer should prepare for an interview by having read the applicant's file beforehand; and (5) the interviewing schedule should be arranged so that the applicant is able to meet either the department chairperson and/or program director.

  15. 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.

  16. BWR Services maintenance training program

    International Nuclear Information System (INIS)

    Cox, J.H.; Chittenden, W.F.

    1979-01-01

    BWR Services has implemented a five-phase program to increase plant availability and capacity factor in operating BWR's. One phase of this program is establishing a maintenance training program on NSSS equipment; the scope encompasses maintenance on both mechanical equipment and electrical control and instrumentation equipment. The program utilizes actual product line equipment for practical Hands-on training. A total of 23 formal courses will be in place by the end of 1979. The General Electric Company is making a multimillion dollar investment in facilities to support this training. These facilities are described

  17. General Employee Radiological Training and Radiological Worker Training: Program management manual

    International Nuclear Information System (INIS)

    1992-10-01

    This manual defines and describes the DOE General Employee Radiological Training (GERT) and Radiological Worker I and II (RW I and II) Training programs. It includes material development requirements, standards and policies, and program administration. This manual applies to General Employee Radiological Training and Radiological Worker Training at all DOE contractor sites. The training materials of both GERT and RW I and II training reflect the requirements identified in the DOE Radiological Control Manual and DOE Order 5480.11. The training programs represent the minimum requirement for the standardized core materials. Each contractor shall implement the program in its entirety and may augment the standardized core materials to increase the general employee and radiological worker level of competency

  18. Team Training (Training at Own Facility) versus Individual Surgeon’s Training (Training at Trainer’s Facility) When Implementing a New Surgical Technique:

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Andresen, Kristoffer; Laursen, Jannie

    2014-01-01

    the teaching there. Methods. An informal literature review was conducted to provide a basis for discussing pros and cons. We also wanted to discuss how many surgeons can be trained in a day and the importance of the demand for a new surgical procedure to ensure a high adoption rate and finally to apply...

  19. The surgical experience of general surgery residents: an analysis of the applicability of the specialty program in General and Digestive Surgery.

    Science.gov (United States)

    Targarona Soler, Eduardo Ma; Jover Navalon, Jose Ma; Gutierrez Saiz, Javier; Turrado Rodríguez, Víctor; Parrilla Paricio, Pascual

    2015-03-01

    Residents in our country have achieved a homogenous surgical training by following a structured residency program. This is due to the existence of specific training programs for each specialty. The current program, approved in 2007, has a detailed list of procedures that a surgeon should have performed in order to complete training. The aim of this study is to analyze the applicability of the program with regard to the number of procedures performed during the residency period. A data collection form was designed that included the list of procedures from the program of the specialty; it was sent in April 2014 to all hospitals with accredited residency programs. In September 2014 the forms were analysed, and a general descriptive study was performed; a subanalysis according to the resident's sex and Autonomous region was also performed. The number of procedures performed according to the number of residents in the different centers was also analyzed. The survey was sent to 117 hospitals with accredited programs, which included 190 resident places. A total of 91 hospitals responded (53%). The training offered adapts in general to the specialty program. The total number of procedures performed in the different sub-areas, in laparoscopic and emergency surgery is correct or above the number recommended by the program, with the exception of esophageal-gastric and hepatobiliary surgery. The sub-analysis according to Autonomous region did not show any significant differences in the total number of procedures, however, there were significant differences in endocrine surgery (P=.001) and breast surgery (P=.042). A total of 55% of residents are female, with no significant differences in distribution in Autonomous regions. However, female surgeons operate more than their male counterparts during the residency period (512±226 vs. 625±244; P<.01). The number of residents in the hospital correlates with the number of procedures performed; the residents with more procedures

  20. 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.

  1. 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

  2. Perceptions of gender-based discrimination during surgical training and practice

    Directory of Open Access Journals (Sweden)

    Adrienne N. Bruce

    2015-02-01

    Full Text Available Background: Women represent 15% of practicing general surgeons. Gender-based discrimination has been implicated as discouraging women from surgery. We sought to determine women's perceptions of gender-based discrimination in the surgical training and working environment. Methods: Following IRB approval, we fielded a pilot survey measuring perceptions and impact of gender-based discrimination in medical school, residency training, and surgical practice. It was sent electronically to 1,065 individual members of the Association of Women Surgeons. Results: We received 334 responses from medical students, residents, and practicing physicians with a response rate of 31%. Eighty-seven percent experienced gender-based discrimination in medical school, 88% in residency, and 91% in practice. Perceived sources of gender-based discrimination included superiors, physician peers, clinical support staff, and patients, with 40% emanating from women and 60% from men. Conclusions: The majority of responses indicated perceived gender-based discrimination during medical school, residency, and practice. Gender-based discrimination comes from both sexes and has a significant impact on women surgeons.

  3. International consensus statement on surgical education and training in an era of reduced working hours.

    Science.gov (United States)

    Collins, John P

    2011-01-01

    An international consensus statement has been developed as a reference on the key principles to be considered during discussions on surgical education and training and the delivery of surgical care in an era of restricted hours. Copyright © 2011. Published by Elsevier Ltd.

  4. Attitudes and Perceptions of Surgical Oncology Fellows on ACGME Accreditation and the Complex General Surgical Oncology Certification.

    Science.gov (United States)

    Lee, David Y; Flaherty, Devin C; Lau, Briana J; Deutsch, Gary B; Kirchoff, Daniel D; Huynh, Kelly T; Lee, Ji-Hey; Faries, Mark B; Bilchik, Anton J

    2015-11-01

    With the first qualifying examination administered September 15, 2014, complex general surgical oncology (CGSO) is now a board-certified specialty. We aimed to assess the attitudes and perceptions of current and future surgical oncology fellows regarding the recently instituted Accreditation Council for Graduate Medical Education (ACGME) accreditation. A 29-question anonymous survey was distributed to fellows in surgical oncology fellowship programs and applicants interviewing at our fellowship program. There were 110 responses (79 fellows and 31 candidates). The response rate for the first- and second-year fellows was 66 %. Ninety-percent of the respondents were aware that completing an ACGME-accredited fellowship leads to board eligibility in CGSO. However, the majority (80 %) of the respondents stated that their decision to specialize in surgical oncology was not influenced by the ACGME accreditation. The fellows in training were concerned about the cost of the exam (90 %) and expressed anxiety in preparing for another board exam (83 %). However, the majority of the respondents believed that CGSO board certification will be helpful (79 %) in obtaining their future career goals. Interestingly, candidate fellows appeared more focused on a career in general complex surgical oncology (p = 0.004), highlighting the impact that fellowship training may have on organ-specific subspecialization. The majority of the surveyed surgical oncology fellows and candidates believe that obtaining board certification in CGSO is important and will help them pursue their career goals. However, the decision to specialize in surgical oncology does not appear to be motivated by ACGME accreditation or the new board certification.

  5. A pilot study of the utility of a laboratory-based spinal fixation training program for neurosurgical residents.

    Science.gov (United States)

    Sundar, Swetha J; Healy, Andrew T; Kshettry, Varun R; Mroz, Thomas E; Schlenk, Richard; Benzel, Edward C

    2016-05-01

    OBJECTIVE Pedicle and lateral mass screw placement is technically demanding due to complex 3D spinal anatomy that is not easily visualized. Neurosurgical and orthopedic surgery residents must be properly trained in such procedures, which can be associated with significant complications and associated morbidity. Current training in pedicle and lateral mass screw placement involves didactic teaching and supervised placement in the operating room. The objective of this study was to assess whether teaching residents to place pedicle and lateral mass screws using navigation software, combined with practice using cadaveric specimens and Sawbones models, would improve screw placement accuracy. METHODS This was a single-blinded, prospective, randomized pilot study with 8 junior neurosurgical residents and 2 senior medical students with prior neurosurgery exposure. Both the study group and the level of training-matched control group (each group with 4 level of training-matched residents and 1 senior medical student) were exposed to a standardized didactic education regarding spinal anatomy and screw placement techniques. The study group was exposed to an additional pilot program that included a training session using navigation software combined with cadaveric specimens and accessibility to Sawbones models. RESULTS A statistically significant reduction in overall surgical error was observed in the study group compared with the control group (p = 0.04). Analysis by spinal region demonstrated a significant reduction in surgical error in the thoracic and lumbar regions in the study group compared with controls (p = 0.02 and p = 0.04, respectively). The study group also was observed to place screws more optimally in the cervical, thoracic, and lumbar regions (p = 0.02, p = 0.04, and p = 0.04, respectively). CONCLUSIONS Surgical resident education in pedicle and lateral mass screw placement is a priority for training programs. This study demonstrated that compared with a

  6. A Targeted E-Learning Program for Surgical Trainees to Enhance Patient Safety in Preventing Surgical Infection

    Science.gov (United States)

    McHugh, Seamus Mark; Corrigan, Mark; Dimitrov, Borislav; Cowman, Seamus; Tierney, Sean; Humphreys, Hilary; Hill, Arnold

    2010-01-01

    Introduction: Surgical site infection accounts for 20% of all health care-associated infections (HCAIs); however, a program incorporating the education of surgeons has yet to be established across the specialty. Methods: An audit of surgical practice in infection prevention was carried out in Beaumont Hospital from July to November 2009. An…

  7. Methods for evaluation of industry training programs

    International Nuclear Information System (INIS)

    Morisseau, D.S.; Roe, M.L.; Persensky, J.J.

    1987-01-01

    The NRC Policy Statement on Training and Qualification endorses the INPO-managed Training Accreditation Program in that it encompasses the elements of effective performance-based training. Those elements are: analysis of the job, performance-based learning objectives, training design and implementation, trainee evaluation, and program evaluation. As part of the NRC independent evaluation of utilities implementation of training improvement programs, the staff developed training review criteria and procedures that address all five elements of effective performance-based training. The staff uses these criteria to perform reviews of utility training programs that have already received accreditation. Although no performance-based training program can be said to be complete unless all five elements are in place, the last two, trainee and program evaluation, are perhaps the most important because they determine how well the first three elements have been implemented and ensure the dynamic nature of training. This paper discusses the evaluation elements of the NRC training review criteria. The discussion will detail the elements of evaluation methods and techniques that the staff expects to find as integral parts of performance-based training programs at accredited utilities. Further, the review of the effectiveness of implementation of the evaluation methods is discussed. The paper also addresses some of the qualitative differences between what is minimally acceptable and what is most desirable with respect to trainee and program evaluation mechanisms and their implementation

  8. Residency evaluation and adherence design study: Young ophthalmologists' perception of their residency programs – Clinical and surgical skills

    Directory of Open Access Journals (Sweden)

    Parikshit Gogate

    2017-01-01

    Full Text Available Background: Residency training is the basis of good clinical and surgical practice. Purpose: The aim is to know the demographics, training experience, and perception of young ophthalmologists to improve the present residency programs in India. Setting: Young ophthalmologists trained in India. Methods: A survey was conducted by the Academic and Research Committee of the All India Ophthalmology Society, in 2014–2016 of young ophthalmologists (those trained between 2002 and 2012, with 2–10 years' postresidency experience to gauge teaching of clinical and surgical skills during the postgraduate residency program. Statistical Analysis: Statistical Package for Social Sciences version 16. Results: Of the 1005 respondents, 531 fulfilled inclusion criteria. Average age was 32.6 years (standard deviation [SD] 4. On a scale of 0–10, clinical skills teaching was graded as (mean, SD: Slit lamp examination (7.2, SD 2.8, indirect ophthalmoscopy (6.2, SD 3.3, gonioscopy (5.7, SD 3.4, perimetry (6.2, SD 3.2, optical coherence tomography (4.6, SD 4, and orthoptic evaluation (4.3, SD 3.1. The mean (SD and median of surgeries performed independently was intracapsular cataract extraction 3.0 (14.9, 0; extracapsular cataract extraction 39.9 (53.2, 18; small incision cataract surgery 75.3 (64.4, 55; phacoemulsification 30 (52.6, 1; pterygium excision 31.5 (43.5, 15; dacryocystectomy 20.3 (38.1, 4; dacryocystorhinostomy 11.7 (26.2, 2; chalazion 46.4 (48.3, 30; trabeculectomies 4 (14.9, 0; strabismus correction 1.4 (4.9, 0; laser-assisted in situ Keratomileusis 1.5 (12.2, 0; retinal detachment 1.5 (12.5, 0; vitrectomy 3.0 (17.0, 0; keratoplasty 5.2 (17.8, 0; eyelid surgery 8.6 (18.9, 2 and ocular emergencies 41.7 (52.4, 20. Observed and assisted surgeries were more common. However, the range of grading was 0–10 in all categories. Conclusion: Residency training in India varies considerably from program to program. Standardization is needed to assure all graduates

  9. Cernavoda NPP operations training programs

    International Nuclear Information System (INIS)

    1993-01-01

    The purpose of this document is to describe the philosophy, content and minimum requirements for the Cernavoda Training Programs for all Station staff and to identify the training department organization and respective responsibilities necessary to provide the required training. The hierarchical documentation and requirements related to these programs is shown in figure Rd-TR1-1

  10. Continuous Curvilinear Capsulorhexis Training and Non-Rhexis Related Vitreous Loss: The Specificity of Virtual Reality Simulator Surgical Training (An American Ophthalmological Society Thesis).

    Science.gov (United States)

    McCannel, Colin A

    2017-08-01

    To assess the specificity of simulation-based virtual reality ophthalmic cataract surgery training on the Eyesi ophthalmic virtual reality surgical simulator, and test the hypothesis that microsurgical motor learning is highly specific. Retrospective educational interventional case series. The rates of vitreous loss and retained lens material, and vitreous loss and retained lens material associated with an errant continuous curvilinear capsulorhexis (CCC) were assessed among 1037 consecutive cataract surgeries performed during four consecutive academic years at a teaching hospital. The data were grouped by Eyesi use and capsulorhexis intensive training curriculum (CITC) completion. The main intervention was the completion of the CITC on the Eyesi. In the Eyesi simulator experience-based stratification, the vitreous loss rate was similar in each group (chi square p=0.95) and was not preceded by an errant CCC in 86.2% for "CITC done at least once", 57.1% for "CITC not done, but some Eyesi use", and 48.9% for "none" training groups (p=4×10-5). Retained lens material overall and occurring among the errant CCC cases was similar among training groups (p=0.82 and p=0.71, respectively). Eyesi capsulorhexis training was not associated with lower vitreous loss rates overall. However, non-errant CCC associated vitreous loss was higher among those who underwent Eyesi capsulorhexis training. Training focused on the CCC portion of cataract surgery may not reduce vitreous loss unassociated with an errant CCC. It is likely that surgical training is highly specific to the task being trained. Residents may need to be trained for all surgical steps with adequate intensity to minimize overall complication rates.

  11. 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.

  12. Guidance for training program evaluation

    International Nuclear Information System (INIS)

    1984-01-01

    An increased concern about the training of nuclear reactor operators resulted from the incident at TMI-2 in 1979. Purpose of this guide is to provide a general framework for the systematic evaluation of training programs for DOE Category-A reactors. The primary goal of such evaluations is to promote continuing quality improvements in the selection, training and qualification programs

  13. Why are junior doctors deterred from choosing a surgical career?

    Science.gov (United States)

    Rogers, Mary E; Creed, Peter A; Searle, Judy

    2012-05-01

    To identify the reasons why interns would not choose a surgical career. This qualitative study used semi-structured telephone interviews to explore the future career choices of 41 junior doctors (14 men, 27 women). Doctors were asked to identify specialties they would not take up, and state why this was the case. Thirty (73.2%) of the 41 interns nominated surgery as a specialty they would not choose. Themes relating to reasons for not wanting to pursue a surgical career included the lifestyle associated with surgery (66.7%), the culture within the surgical work environment (53.3%), the lack of interest in performing surgical work (36.7%), and the training requirements associated with surgery (33.3%). Both sexes had similar reasons for not wanting to choose a surgical career; but additionally, women referred to the male domination of surgery, and the difficulty and inflexibility of the training program as deterrents. Efforts are needed to promote interest in surgery as a career especially for women, to improve the surgical work environment so that medical students and junior doctors have exposure to positive role models and surgical placements, and to provide a more flexible approach to surgical training.

  14. Current approaches to journal club by general surgery programs within the Southwestern surgical congress.

    Science.gov (United States)

    Shifflette, Vanessa; Mitchell, Chris; Mangram, Alicia; Dunn, Ernest

    2012-01-01

    Journal club (JC) is a well-recognized education tool for many postgraduate medical education programs. Journal club helps residents learn critical analytic skills and keep up to date with current medical practices. To our knowledge, there is minimal evidence in the current literature detailing modern JC practices of general surgery training programs. Our study attempts to define how general surgery residency programs are implementing JC in their training process. We distributed by mail a 14-question survey to general surgery program directors within the Southwestern Surgical Congress. These surveys were redistributed 1 month after the initial attempt. The responses were collected and analyzed. Survey questions aimed to define JC practice characteristics, such as where JC is held, when JC is held, who directs JC, what journals are used, the perceived importance of JC, and average attendance. The surveys were sent to 32 program directors (PDs), which included 26 university and 6 community-based programs. We received responses from 26 (81%) PDs. Ninety-two percent of the programs have a consistent journal club (JC). Most JCs meet monthly (64%) or weekly (16%). The meeting places ranged from conference rooms (60%), faculty homes (20%), restaurants (8%), or in the hospital (12%). The meeting times were divided between morning (29%), midday (29%), and evening (42%). Most JCs lasted between 1 and 2 hours (88%), reviewed 1-4 articles (88%), and are attended by more than 60% of residents routinely (75%). Half of the programs (50%) had 3-4 faculty members present during discussion; 29% of the programs had only 1-2 faculty present. The articles were selected from more than 10 different journals. Seventy-five percent of the programs used the American Journal of Surgery and Annals of Surgery to find articles; only 13% of the programs used evidence-based reviews in surgery. PDs believe JC is very beneficial (42%), moderately beneficial (42%), or only fairly beneficial (16

  15. Wearable Technology for Global Surgical Teleproctoring.

    Science.gov (United States)

    Datta, Néha; MacQueen, Ian T; Schroeder, Alexander D; Wilson, Jessica J; Espinoza, Juan C; Wagner, Justin P; Filipi, Charles J; Chen, David C

    2015-01-01

    In underserved communities around the world, inguinal hernias represent a significant burden of surgically-treatable disease. With traditional models of international surgical assistance limited to mission trips, a standardized framework to strengthen local healthcare systems is lacking. We established a surgical education model using web-based tools and wearable technology to allow for long-term proctoring and assessment in a resource-poor setting. This is a feasibility study examining wearable technology and web-based performance rating tools for long-term proctoring in an international setting. Using the Lichtenstein inguinal hernia repair as the index surgical procedure, local surgeons in Paraguay and Brazil were trained in person by visiting international expert trainers using a formal, standardized teaching protocol. Surgeries were captured in real-time using Google Glass and transmitted wirelessly to an online video stream, permitting real-time observation and proctoring by mentoring surgeon experts in remote locations around the world. A system for ongoing remote evaluation and support by experienced surgeons was established using the Lichtenstein-specific Operative Performance Rating Scale. Data were collected from 4 sequential training operations for surgeons trained in both Paraguay and Brazil. With continuous internet connectivity, live streaming of the surgeries was successful. The Operative Performance Rating Scale was immediately used after each operation. Both surgeons demonstrated proficiency at the completion of the fourth case. A sustainable model for surgical training and proctoring to empower local surgeons in resource-poor locations and "train trainers" is feasible with wearable technology and web-based communication. Capacity building by maximizing use of local resources and expertise offers a long-term solution to reducing the global burden of surgically-treatable disease. Copyright © 2015 Association of Program Directors in Surgery

  16. 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...

  17. Career outcomes of nondesignated preliminary general surgery residents at an academic surgical program.

    Science.gov (United States)

    Ahmad, Rima; Mullen, John T

    2013-01-01

    There remains a debate as to whether nondesignated preliminary (NDP) positions in surgery ultimately translate into successful surgical careers for those who pursue them. We sought to identify the success with which our NDP residents were able to transition to their desired career and what, if any, factors contributed to their success. The records of all NDP residents accepted into the Massachusetts General Hospital General Surgery Residency Program from 1995 to 2010 were examined and long-term follow-up was completed. Thirty-four NDP residents were identified, including 26.5% US graduates and 73.5% international medical graduates. At the end of the initial preliminary year, 30 (88%) got placed in a postgraduate residency program, whereas 4 (12%) pursued other career paths. Of those who got placed, 25 (83%) attained surgical residency positions, including 17 (57%) who continued as preliminary residents at our institution and 8 (27%) who got placed in categorical surgical positions at other programs. After multiple preliminary years, 15 of 17 achieved a categorical position, of which, 93% were in surgical fields. Overall, 64.7% of all entering NDP residents eventually went on to have careers in general surgery (50%) or surgical subspecialties (14.7%), and 24 of 34 (71%) fulfilled their desired career goals. No factor predicted success. From 1995 to 2012 there have been 15 midlevel (11 postgraduate year 4) vacancies in our program, 4 of which were filled by preliminary residents, 2 from our program and 2 from elsewhere. All have gone on to board certifications and careers in surgery. More than 70% of NDP residents in our program successfully transitioned to their desired career paths, many achieving categorical surgical positions and academic surgical careers, thus demonstrating the benefit of this track to both residency programs and trainees. © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  18. Blood transfusion knowledge of surgical residents: is an educational intervention effective?

    Science.gov (United States)

    Champion, Caitlin; Saidenberg, Elianna; Lampron, Jacinthe; Pugh, Debra

    2017-04-01

    Evidence-based transfusion education for surgical residents is crucial to improving practice. A pilot study was undertaken to assess the effectiveness of an education module for improving transfusion knowledge among surgical residents. Modules were developed and delivered by experts in surgery and transfusion medicine. They were delivered to residents in their first 2 years of training (Surgical Foundations), and to General Surgery residents across all years of training. Premodule and postmodule and retention knowledge assessments were used to assess efficacy. Median assessment scores for each group were compared using a two-sample Wilcoxon rank-sum analysis. Chi-square tests were used to compare each group's correct response rates for each question across the three tests. Median assessment scores of residents in the Surgical Foundations program improved from a mean of 60% premodule to 80% postmodule and remained at 80% in the retention assessment (p transfusion dose, preoperative blood management, management of reactions, and informed consent (p Transfusion knowledge of surgical residents was improved by a collaborative educational initiative. This could serve as a model for other training programs to improve resident knowledge of evidence-based transfusion practices. The efficacy of such interventions in changing practice remains untested. © 2017 AABB.

  19. Formal mentorship in a surgical residency training program: a prospective interventional study.

    Science.gov (United States)

    Zhang, Han; Isaac, Andre; Wright, Erin D; Alrajhi, Yaser; Seikaly, Hadi

    2017-02-13

    Otolaryngology-Head and Neck surgery resident physicians (OHNSR) have a high prevalence of burnout, job dissatisfaction and stress as shown within the literature. Formal mentorship programs (FMP) have a proven track record of enhancing professional development and academic success. More importantly FMP have an overall positive impact on residents and assist in improving job satisfaction. The purpose of the study is to determine the effects of a FMP on the well-being of OHNSR. A FMP was established and all OHNSR participation was voluntary. Eight OHNSR participated in the program. Perceived Stress Survey (PSS) and the Maslach Burnout Inventory (MBI) were administered at baseline and then at 3, 6, 9, and 12 month intervals. World Health Quality of Life-Bref Questionnaire (WH-QOL) was administered at baseline and at 12 months. Baseline statistics found a significant burden of stress and burnout with an average PSS of 18.5 with a high MBI of 47.6, 50.6, and 16.5 for the emotional, depersonalization, and personal achievement domains respectively. Quality of life was also found to be low with a WH-QOL score of 71.9. After implementation of the FMP, PSS was reduced to 14.5 at 3 months (p = 0.174) and a statistically significant lower value of 7.9 at 12 months (p = 0.001). Participants were also found to have lower emotional scores (14.9, p values using the WH-QOL was also found to be significantly improved (37.5, P = 0.003) with statistically significant lower scores for the physical health (33.9, p = 0.003), psychological (41.1, p = 0.001), social relationship (46.9, p = 0.019), and environment (53.5, p = 0.012) domains. This is the first study to show that FMP can potentially alleviate high levels of stress and burnout within a surgical residency program and achieve higher levels of personal satisfaction as well as overall quality of life.

  20. Thoracic surgical resident education: a costly endeavor.

    Science.gov (United States)

    Calhoon, John H; Baisden, Clint; Holler, Ben; Hicks, George L; Bove, Ed L; Wright, Cameron D; Merrill, Walter H; Fullerton, Dave A

    2014-12-01

    We sought to define an accurate measure of thoracic surgical education costs. Program directors from six distinct and differently sized and geographically located thoracic surgical training programs used a common template to provide estimates of resident educational costs. These data were reviewed, clarifying questions or discrepancies when noted and using best estimates when exact data were unavailable. Subsequently, a composite of previously published cost-estimation products was used to capture accurate cost data. Data were then compiled and averaged to provide an accurate picture of all costs associated with thoracic surgical education. Before formal accounting was performed, the estimated average for all programs was approximately $250,000 per year per resident. However, when formal evaluations by the six programs were performed, the annual cost of resident education ranged from $330,000 to $667,000 per year per resident. The average cost of $483,000 per year was almost double the initial estimates. Variability was noted by region and size of program. Faculty teaching costs varied from $208,000 to $346,000 per year. Simulation costs ranged from $0 to $80,000 per year. Resident savings to program ranged from $0 to $135,000 per year and averaged $37,000 per year per resident. Thoracic surgical education costs are considerably higher than initial estimates from program directors and probably represent an unappreciated source of financial burden for cardiothoracic surgical educational programs. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  1. 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.

  2. Visual-spatial ability is more important than motivation for novices in surgical simulator training: a preliminary study.

    Science.gov (United States)

    Schlickum, Marcus; Hedman, Leif; Felländer-Tsai, Li

    2016-02-21

    To investigate whether surgical simulation performance and previous video gaming experience would correlate with higher motivation to further train a specific simulator task and whether visual-spatial ability would rank higher in importance to surgical performance than the above. It was also examined whether or not motivation would correlate with a preference to choose a surgical specialty in the future and if simulator training would increase the interest in choosing that same work field. Motivation and general interest in surgery was measured pre- and post-training in 30 medical students at Karolinska Institutet who were tested in a laparoscopic surgical simulator in parallel with measurement of visual-spatial ability and self-estimated video gaming experience. Correlations between simulator performance metrics, visual-spatial ability and motivation were statistically analyzed using regression analysis. A good result in the first simulator trial correlated with higher self-determination index (r =-0.46, p=0.05) in male students. Visual-spatial ability was the most important underlying factor followed by intrinsic motivation score and finally video gaming experience (p=0.02, p=0.05, p=0.11) regarding simulator performance in male students. Simulator training increased interest in surgery when studying all subjects (p=0.01), male subjects (p=0.02) as well as subjects with low video gaming experience (p=0.02). This preliminary study highlights individual differences regarding the effect of simulator training on motivation that can be taken into account when designing simulator training curricula, although the sample size is quite small and findings should be interpreted carefully.

  3. DOE Radiological Control Manual Core Training Program

    International Nuclear Information System (INIS)

    Scott, H.L.; Maisler, J.

    1993-01-01

    Over the past year, the Department of Energy (DOE) Office of Health (EH-40) has taken a leading role in the development of new standardized radiological control training programs for use throughout the DOE complex. The Department promulgated its Radiological Control (RadCon) Manual in June 1992. To ensure consistent application of the criteria presented in the RadCon Manual, standardized radiological control core training courses and training materials have been developed for implementation at all DOE facilities. In producing local training programs, standardized core courses are to be supplemented with site-specific lesson plans, viewgraphs, student handbooks, qualification standards, question banks, and wallet-sized training certificates. Training programs for General Employee Radiological Training, Radiological Worker I and II Training, and Radiological Control Technician Training have been disseminated. Also, training committees under the direction of the Office of Health (EH-40) have been established for the development of additional core training courses, development of examination banks, and the update of the existing core training courses. This paper discusses the current activities and future direction of the DOE radiological control core training program

  4. 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.

  5. A structured, extended training program to facilitate adoption of new techniques for practicing surgeons.

    Science.gov (United States)

    Greenberg, Jacob A; Jolles, Sally; Sullivan, Sarah; Quamme, Sudha Pavuluri; Funk, Luke M; Lidor, Anne O; Greenberg, Caprice; Pugh, Carla M

    2018-01-01

    Laparoscopic inguinal hernia repair has been shown to have significant benefits when compared to open inguinal hernia repair, yet remains underutilized in the United States. The traditional model of short, hands-on, cognitive courses to enhance the adoption of new techniques fails to lead to significant levels of practice implementation for most surgeons. We hypothesized that a comprehensive program would facilitate the adoption of laparoscopic inguinal hernia repair (TEP) for practicing surgeons. A team of experts in simulation, coaching, and hernia care created a comprehensive training program to facilitate the adoption of TEP. Three surgeons who routinely performed open inguinal hernia repair with greater than 50 cases annually were recruited to participate in the program. Coaches were selected based on their procedural expertise and underwent formal training in surgical coaching. Participants were required to evaluate all aspects of the educational program and were surveyed out to one year following completion of the program to assess for sustained adoption of TEP. All three participants successfully completed the first three steps of the seven-step program. Two participants completed the full course, while the third dropped out of the program due to time constraints and low case volume. Participant surgeons rated Orientation (4.7/5), GlovesOn training (5/5), and Preceptored Cases (5/5) as highly important training activities that contributed to advancing their knowledge and technical performance of the TEP procedure. At one year, both participants were performing TEPs for "most of their cases" and were confident in their ability to perform the procedure. The total cost of the program including all travel, personal coaching, and simulation was $8638.60 per participant. Our comprehensive educational program led to full and sustained adoption of TEP for those who completed the course. Time constraints, travel costs, and case volume are major considerations for

  6. 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.

  7. Customer Satisfaction with Training Programs.

    Science.gov (United States)

    Mulder, Martin

    2001-01-01

    A model for evaluating customer satisfaction with training programs was tested with training purchasers. The model confirmed two types of projects: training aimed at achieving learning results and at changing job performance. The model did not fit for training intended to support organizational change. (Contains 31 references.) (SK)

  8. Supervisor's role in training programs as a manager of learning program

    Directory of Open Access Journals (Sweden)

    2011-06-01

    Full Text Available According to the training literature, a supervisor's role in training programs has two major elements: supervisor support and supervisor communication. The ability of supervisors to play effective roles in training programs may increase employees' motivation to learn. The nature of this relationship is interesting, but the role of supervisor's role as a predicting variable is less emphasized in a training program models. Therefore, this study was conducted to examine the effect of supervisor's role in training programs on motivation to learn using 152 usable questionnaires gathered from non-academic employees who have worked in a technological based public university, Malaysia. The outcomes of stepwise regression analysis showed that the supervisor support and supervisor communication significantly associated with motivation to learn. Statistically, this result demonstrates that supervisor's role in training programs does act as an important predictor of motivation to learn in the organizational sample. In addition, discussion, implication and conclusion are elaborated.

  9. 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.

  10. 25 CFR 26.30 - Does the Job Training Program provide part-time training or short-term training?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Does the Job Training Program provide part-time training or short-term training? 26.30 Section 26.30 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES JOB PLACEMENT AND TRAINING PROGRAM Training Services § 26.30 Does the Job Training...

  11. 14 CFR 121.407 - Training program: Approval of airplane simulators and other training devices.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Training program: Approval of airplane... Program § 121.407 Training program: Approval of airplane simulators and other training devices. (a) Each airplane simulator and other training device that is used in a training course permitted under § 121.409...

  12. 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.

  13. 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…

  14. Tactical Vulnerability Assessment Training Program

    International Nuclear Information System (INIS)

    Al-Ayat, R.A.; Judd, B.R.; Renis, T.A.; Paulus, W.K.; Winblad, A.G.; Graves, B.R.

    1987-01-01

    The Department of Energy sponsors a 9-day training program for individuals who are responsible for evaluating and planning safeguards systems and for preparing DOE Master and Security Agreements (MSSAs). These agreements between DOE headquarters and operations offices establish required levels of protection. The curriculum includes: (1) the nature of potential insider and outsider threats involving theft or diversion of special nuclear material, (2) use of computerized tools for evaluating the effectiveness of physical protection and material control and accountability systems, and (3) methods for analyzing the benefits and costs of safeguards improvements and for setting priorities among proposed upgrades. The training program is varied and high interactive. Presentations are intermixed with class discussions and ''hands-on'' analysis using computer tools. At the end of the program, participants demonstrate what they have learned in a two-and-one-half day ''field exercise,'' which is conducted on a facility scale-model. The training program has been conducted six times and has been attended by representatives of all DOE facilities. Additional sessions are planned at four-month intervals. This paper describes the training program, use of the tools in preparing MSSAs for various DOE sites, and recent extensions and refinements of the evaluation tools

  15. Tactical Vulnerability Assessment Training Program

    International Nuclear Information System (INIS)

    Al-Ayat, R.A.; Judd, B.R.; Renis, T.A.; Paulus, W.K.; Winblad, A.E.; Graves, B.R.

    1987-01-01

    The Department of Energy sponsors a 9-day training program for individual who are responsible for evaluating and planning safeguards systems and for preparing DOE Master and Security Agreements (MSSAs). These agreements between DOE headquarters and operations offices establish required levels of protection. The curriculum includes: (1) the nature of potential insider and outsider threats involving theft or diversion of special nuclear material, (2) use of computerized tools for evaluating the effectiveness of physical protection and material control and acoountability systems, and (3) methods for analyzing the benefits and costs of safeguards improvements and for setting priorities among proposed upgrades. The training program is varied and highly interactive. Presentations are intermixed with class discussions and ''hands-on'' analysis using computer tools. At the end of the program, participants demonstrate what they have learned in a two-and-one-half day ''field excercise,'' which is conducted on a facility scale-model. The training programs has been conducted six times and has been attended by representatives of all DOE facilities. Additional sessions are planned at four-month intervals. This paper describes the training program, use of the tools in preparing MSSAs for various DOE sites, and recent extensions and refinements of the evaluation tools

  16. Global curriculum in surgical oncology.

    Science.gov (United States)

    Are, C; Berman, R S; Wyld, L; Cummings, C; Lecoq, C; Audisio, R A

    2016-06-01

    The significant global variations in surgical oncology training paradigms can have a detrimental effect on tackling the rising global cancer burden. While some variations in training are essential to account for the differences in types of cancer and biology, the fundamental principles of providing care to a cancer patient remain the same. The development of a global curriculum in surgical oncology with incorporated essential standards could be very useful in building an adequately trained surgical oncology workforce, which in turn could help in tackling the rising global cancer burden. The leaders of the Society of Surgical Oncology and European Society of Surgical Oncology convened a global curriculum committee to develop a global curriculum in surgical oncology. A global curriculum in surgical oncology was developed to incorporate the required domains considered to be essential in training a surgical oncologist. The curriculum was constructed in a modular fashion to permit flexibility to suit the needs of the different regions of the world. Similarly, recognizing the various sociocultural, financial and cultural influences across the world, the proposed curriculum is aspirational and not mandatory in intent. A global curriculum was developed which may be considered as a foundational scaffolding for training surgical oncologists worldwide. It is envisioned that this initial global curriculum will provide a flexible and modular scaffolding that can be tailored by individual countries or regions to train surgical oncologists in a way that is appropriate for practice in their local environment. Copyright © 2016 Society of Surgical Oncology, European Society of Surgical Oncology. Published by Elsevier Ltd.. All rights reserved.

  17. Paediatric Abdominal Surgical Emergencies in a General Surgical ...

    African Journals Online (AJOL)

    ... organized for general surgeons undertaking paediatric surgical emergencies. More paediatric surgeons should be trained and more paediatric surgical units should established in the country. Key Words: Paediatric Abdominal Surgical Emergencies; Paediatric Surgeons, General Surgeons. Journal of College of Medicine ...

  18. Video games and surgical ability: a literature review.

    Science.gov (United States)

    Lynch, Jeremy; Aughwane, Paul; Hammond, Toby M

    2010-01-01

    Surgical training is rapidly evolving because of reduced training hours and the reduction of training opportunities due to patient safety concerns. There is a popular conception that video game usage might be linked to improved operating ability especially those techniques involving endoscopic modalities. If true this might suggest future directions for training. A search was made of the MEDLINE databases for the MeSH term, "Video Games," combined with the terms "Surgical Procedures, Operative," "Endoscopy," "Robotics," "Education," "Learning," "Simulators," "Computer Simulation," "Psychomotor Performance," and "Surgery, Computer-Assisted,"encompassing all journal articles before November 2009. References of articles were searched for further studies. Twelve relevant journal articles were discovered. Video game usage has been studied in relationship to laparoscopic, gastrointestinal endoscopic, endovascular, and robotic surgery. Video game users acquire endoscopic but not robotic techniques quicker, and training on video games appears to improve performance. Copyright (c) 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. Peer-mentoring junior surgical trainees in the United Kingdom: a pilot program.

    Science.gov (United States)

    Vulliamy, Paul; Junaid, Islam

    2012-04-16

    Peer-mentoring has attracted substantial interest in various healthcare professions, but has not been formally integrated into postgraduate surgical training. This study aimed to assess the feasibility and acceptability of a peer-mentor scheme among junior surgical trainees in the United Kingdom. Trainees entering the first year of core surgical training (CST) in a single postgraduate school of surgery were allocated a mentor in the second year of CST. Allocation was based on location of the initial clinical placement. An anonymised questionnaire regarding the mentorship scheme was sent to all participants in the third month following its introduction. 18 trainees participated in the scheme, of whom 12 (67%) responded to the questionnaire. All respondents had made contact with their allocated mentor or mentee, and no trainees had opted out of the scheme. Areas in which the mentees received guidance included examinations (83%), CV development (67%), and workplace-based assessments (67%). All respondents felt that the mentor scheme was a good addition to CST. Suggestions for improvement of the scheme included introduction of structured meetings and greater engagement with allocated mentors. A pilot peer-mentoring scheme was well received by junior surgical trainees. Consideration should be given to expansion of this scheme and more rigorous assessment of its value.

  20. Training Program Handbook: A systematic approach to training

    Energy Technology Data Exchange (ETDEWEB)

    1994-08-01

    This DOE handbook describes a systematic method for establishing and maintaining training programs that meet the requirements and expectations of DOE Orders 5480.18B and 5480.20. The systematic approach to training includes 5 phases: Analysis, design, development, implementation, and evaluation.

  1. Radiological control technician: Training program management manual

    International Nuclear Information System (INIS)

    1992-10-01

    This manual defines and describes the DOE Radiological Control Technician Core Training Program qualification and training process, material development requirements, standards and policies, and administration. The manual applies to Radiological Control Technician Training Programs at all DOE contractor sites

  2. 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

  3. 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.

  4. Play Therapy Training among School Psychology, Social Work, and School Counseling Graduate Training Programs

    Science.gov (United States)

    Pascarella, Christina Bechle

    2012-01-01

    This study examined play therapy training across the nation among school psychology, social work, and school counseling graduate training programs. It also compared current training to previous training among school psychology and school counseling programs. A random sample of trainers was selected from lists of graduate programs provided by…

  5. Evaluation of training programs: A pragmatic perspective

    International Nuclear Information System (INIS)

    Wilkinson, J.D.

    1996-01-01

    The Canadian nuclear regulatory agency endorses the Systematic Approach to Training (SAT) as the most reliable method of providing effective, efficient training to Nuclear Power Plant (NPP) personnel. However the benefits of SAT cannot be realized unless all five phases of SAT are implemented. This is particularly true with respect to evaluation. Although each phase of SAT builds on the preceding one, the evaluation phase continuously feeds back into each of the others and also provides the means to verify the entire training programme building process. It is useful, therefore, to examine the issues relating to the what, why, who, when and how of training programme evaluation. ''What'' identifies the various aspects of the training programme to be evaluated, including the need for training, the training standard, the task list, trainer competence, test results, training results, program acceptance and numerous indicators that identify a need for evaluation. ''Why'' addresses legal and regulatory aspects, resource management, worker and public safety, worker and trainer competence and morale, and the cost/benefit of the training program. ''Who'' examines the need to involve trainers, trainees, plant subject matter experts (SMEs), and both plant and training centre supervisory and management staff. ''When'' addresses time-related concerns such as the importance of ensuring at the outset that the training program is actually needed, the necessity of responding promptly to local, national and world events, changes in legal and regulatory responsibilities, and the overriding importance of timely, routine training program evaluations. ''How'' describes the process of conducting a training program evaluation, and addresses the relationships of these five aspects of evaluation to each other. (author). 10 refs

  6. [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.

  7. BLENDED LEARNING STRATEGY IN TEACHER TRAINING PROGRAMS

    Directory of Open Access Journals (Sweden)

    Marian F. Byrka

    2017-12-01

    Full Text Available The article examines the implementation of blended learning strategy in teacher training programs as an innovation in online learning. The blended learning idea comes from blending elements which use online technology with more traditional face-to-face teaching in the same course. The article analyses teacher training programs offered by Chernivtsi Regional Institute of Postgraduate Pedagogical Education. Additional data were gathered through a questionnaire administered to teachers who attended training courses. The characteristics of blended learning strategy, its benefits and limitations for teacher training are supported by a review of literature. The article closes with the comparison of curriculum components (content delivery, learner activities, materials, and required competences between traditional and blended learning teacher training programs. Having obvious benefits in teacher training programs, the implementation of blended learning strategy sets some additional requirements to a learner, as well as to course instructors and lectors.

  8. Studying creativity training programs: A methodological analysis

    DEFF Research Database (Denmark)

    Valgeirsdóttir, Dagný; Onarheim, Balder

    2017-01-01

    Throughout decades of creativity research, a range of creativity training programs have been developed, tested, and analyzed. In 2004 Scott and colleagues published a meta‐analysis of all creativity training programs to date, and the review presented here sat out to identify and analyze studies...... published since the seminal 2004 review. Focusing on quantitative studies of creativity training programs for adults, our systematic review resulted in 22 publications. All studies were analyzed, but comparing the reported effectiveness of training across studies proved difficult due to methodological...... inconsistencies, variations in reporting of results as well as types of measures used. Thus a consensus for future studies is called for to answer the question: Which elements make one creativity training program more effective than another? This is a question of equal relevance to academia and industry...

  9. How to Buy Training Programs.

    Science.gov (United States)

    Geber, Beverly

    1989-01-01

    Discusses how to select the best training program for your needs. Includes information on deciding whether to develop your own program or buy one; identifying the kind of program you need; examining what is available; networking; choosing a supplier; and evaluating programs. (JOW)

  10. 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.

  11. Program Director Perceptions of Surgical Resident Training and Patient Care under Flexible Duty Hour Requirements.

    Science.gov (United States)

    Saadat, Lily V; Dahlke, Allison R; Rajaram, Ravi; Kreutzer, Lindsey; Love, Remi; Odell, David D; Bilimoria, Karl Y; Yang, Anthony D

    2016-06-01

    The Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial was a national, cluster-randomized, pragmatic, noninferiority trial of 117 general surgery programs, comparing standard ACGME resident duty hour requirements ("Standard Policy") to flexible, less-restrictive policies ("Flexible Policy"). Participating program directors (PDs) were surveyed to assess their perceptions of patient care, resident education, and resident well-being during the study period. A survey was sent to all PDs of the general surgery residency programs participating in the FIRST trial (N = 117 [100% response rate]) in June and July 2015. The survey compared PDs' perceptions of the duty hour requirements in their arm of the FIRST trial during the study period from July 1, 2014 to June 30, 2015. One hundred percent of PDs in the Flexible Policy arm indicated that residents used their additional flexibility in duty hours to complete operations they started or to stabilize a critically ill patient. Compared with the Standard Policy arm, PDs in the Flexible Policy arm perceived a more positive effect of duty hours on the safety of patient care (68.9% vs 0%; p care (98.3% vs 0%; p care (71.8%), continuity of care (94.0%), quality of resident education (83.8%), and resident well-being (55.6%) would be improved with a hypothetical permanent adoption of more flexible duty hours. Program directors involved in the FIRST trial perceived improvements in patient safety, continuity of care, and multiple aspects of resident education and well-being with flexible duty hours. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Psychological Assessment Training in Clinical Psychology Doctoral Programs.

    Science.gov (United States)

    Mihura, Joni L; Roy, Manali; Graceffo, Robert A

    2017-01-01

    We surveyed American Psychological Association-accredited clinical psychology doctoral programs' (n = 83) training in psychological assessment-specifically, their coverage of various assessment topics and tests in courses and practica, and whether the training was optional or required. We report results overall and separately per training model (clinical science, scientist-practitioner, and practitioner-focused). Overall, our results suggest that psychological assessment training is as active, or even more active, than in previous years. Areas of increased emphasis include clinical interviewing and psychometrics; multimethod, outcomes, health, and collaborative or therapeutic assessment; and different types of cognitive and self-report personality tests. All or almost all practice-focused programs offered training with the Thematic Apperception Test and Rorschach compared to about half of the scientist-practitioner programs and a third of the clinical science programs. Although almost all programs reported teaching multimethod assessment, what constitutes different methods of assessing psychopathology should be clarified in future studies because many programs appear to rely on one method-self-report (especially clinical science programs). Although doctoral programs covered many assessment topics and tests in didactic courses, there appears to be a shortage of program-run opportunities for students to obtain applied assessment training. Finally, we encourage doctoral programs to be familiar with (a) internships' assessment expectations and opportunities, (b) the professional guidelines for assessment training, and (c) the American Psychological Association's requirements for preinternship assessment competencies.

  13. Criteria to evaluate SAT-based training programs

    International Nuclear Information System (INIS)

    Arjona, O.; Venegas, M.; Rodriguez, L.; Lopez, M.

    1997-01-01

    This paper present some coefficients of error obtained to evaluate the quality of the design development and implementation of SAT-based personnel training programs. With the attainment of these coefficients, with the use of the GESAT system, is facilitated the continuos evaluation of training programs and the main deficiencies in the design, development and implementation of training programs are obtained, through the comparison between the program features and their standards or wanted features and doing an statistics analysis of the data kept in the GESAT system

  14. Current Status of Nutrition Training in Graduate Medical Education From a Survey of Residency Program Directors: A Formal Nutrition Education Course Is Necessary.

    Science.gov (United States)

    Daley, Brian J; Cherry-Bukowiec, Jill; Van Way, Charles W; Collier, Bryan; Gramlich, Leah; McMahon, M Molly; McClave, Stephen A

    2016-01-01

    Nutrition leaders surmised graduate medical nutrition education was not well addressed because most medical and surgical specialties have insufficient resources to teach current nutrition practice. A needs assessment survey was constructed to determine resources and commitment for nutrition education from U.S. graduate medical educators to address this problem. An online survey of 36 questions was sent to 495 Accreditation Council for Graduate Medical Education (ACGME) Program Directors in anesthesia, family medicine, internal medicine, pediatrics, obstetrics/gynecology, and general surgery. Demographics, resources, and open-ended questions were included. There was a 14% response rate (72 programs), consistent with similar studies on the topic. Most (80%) of the program directors responding were from primary care programs, the rest surgical (17%) or anesthesia (3%). Program directors themselves lacked knowledge of nutrition. While some form of nutrition education was provided at 78% of programs, only 26% had a formal curriculum and physicians served as faculty at only 53%. Sixteen programs had no identifiable expert in nutrition and 10 programs stated that no nutrition training was provided. Training was variable, ranging from an hour of lecture to a month-long rotation. Seventy-seven percent of program directors stated that the required educational goals in nutrition were not met. The majority felt an advanced course in clinical nutrition should be required of residents now or in the future. Nutrition education in current graduate medical education is poor. Most programs lack the expertise or time commitment to teach a formal course but recognize the need to meet educational requirements. A broad-based, diverse universal program is needed for training in nutrition during residency. © 2015 American Society for Parenteral and Enteral Nutrition.

  15. Student retention in athletic training education programs.

    Science.gov (United States)

    Dodge, Thomas M; Mitchell, Murray F; Mensch, James M

    2009-01-01

    The success of any academic program, including athletic training, depends upon attracting and keeping quality students. The nature of persistent students versus students who prematurely leave the athletic training major is not known. Understanding the profiles of athletic training students who persist or leave is important. To (1) explore the relationships among the following variables: anticipatory factors, academic integration, clinical integration, social integration, and motivation; (2) determine which of the aforementioned variables discriminate between senior athletic training students and major changers; and (3) identify which variable is the strongest predictor of persistence in athletic training education programs. Descriptive study using a qualitative and quantitative mixed-methods approach. Thirteen athletic training education programs located in District 3 of the National Athletic Trainers' Association. Ninety-four senior-level athletic training students and 31 college students who changed majors from athletic training to another degree option. Data were collected with the Athletic Training Education Program Student Retention Questionnaire (ATEPSRQ). Data from the ATEPSRQ were analyzed via Pearson correlations, multivariate analysis of variance, univariate analysis of variance, and a stepwise discriminant analysis. Open-ended questions were transcribed and analyzed using open, axial, and selective coding procedures. Member checks and peer debriefing techniques ensured trustworthiness of the study. Pearson correlations identified moderate relationships among motivation and clinical integration (r = 0.515, P accounting for 37.2% of the variance between groups. The theoretic model accurately classified 95.7% of the seniors and 53.8% of the major changers. A common theme emerging from the qualitative data was the presence of a strong peer-support group that surrounded many of the senior-level students. Understanding student retention in athletic training is

  16. 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

  17. 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.

  18. The effect of a simple educational intervention on interest in early abortion training among family medicine residents.

    Science.gov (United States)

    Wu, Justine P; Bennett, Ian; Levine, Jeffrey P; Aguirre, Abigail Calkins; Bellamy, Scarlett; Fleischman, Joan

    2006-06-01

    We aimed to assess the effect of an educational intervention on the interest in and support for abortion training among family medicine residents. We conducted a cross-sectional survey before and after an educational lecture on medical and surgical abortion in primary care among 89 residents in 10 New Jersey family medicine programs. Before the lecture, there was more interest in medical abortion training than surgical abortion. Resident interest in surgical abortion and overall support for abortion training increased after the educational intervention (p<.01). Efforts to develop educational programs on early abortion care may facilitate the integration of abortion training in family medicine.

  19. 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.

  20. Perceptions regarding cardiothoracic surgical training at Veterans Affairs hospitals.

    Science.gov (United States)

    Bakaeen, Faisal G; Stephens, Elizabeth H; Chu, Danny; Holman, William L; Vaporciyan, Ara A; Merrill, Walter H; Grover, Frederick L

    2011-05-01

    With cardiothoracic education going through a critical phase of reevaluation and adaptation, we investigated perceptions of Veterans Affairs hospitals in cardiothoracic training. A content-validated survey was distributed electronically to 676 cardiothoracic surgery residents, recent cardiothoracic graduates (on or after June 2006), cardiothoracic surgery chairpersons, program directors, associate program directors, and section heads. The Cardiothoracic Surgery Network was used to identify target recipients and their e-mail addresses. Forty-three percent of the target recipients (292/676) completed the survey. Of those who were residents, 59% (65/111) rotated at a Veterans Affairs hospital during their cardiothoracic training; this rotation accounted for 25% or more of the total training period for 19% of them (21/111). A Veterans Affairs appointment was held by 42% of program directors/chairpersons (20/48) and 24% of graduates, associate program directors, and section heads (31/129). An affiliation with a Veterans Affairs hospital was rated as somewhat to very beneficial by 93% of the responders (273/292), and the cardiothoracic training received at Veterans Affairs facilities was rated as good to excellent by 73% of the responders (213/292). Sixty-nine percent of respondents (201/292) reported the operating room environment at Veterans Affairs hospitals to be at least as conducive to learning as that at the affiliate teaching hospital, and 76% (223/292) indicated that residents get more autonomy and hands-on experience at Veterans Affairs institutions. In addition, 64% of responders (188/292) reported that they would seek or recommend a Veterans Affairs job. Responses were positive toward the Veterans Affairs system regardless of whether the responder had any Veterans Affairs affiliation (ie, appointment as staff or rotation as resident); however, a Veterans Affairs affiliation was associated with a higher rate of positive responses regarding Veterans Affairs

  1. 76 FR 2147 - UAW-Chrysler National Training Center Technology Training Joint Programs Staff, Detroit, MI; UAW...

    Science.gov (United States)

    2011-01-12

    ...-Chrysler National Training Center Technology Training Joint Programs Staff, Detroit, MI; UAW-Chrysler Technical Training Center Technology Training Joint Programs Staff, Warren, MI; Notice of Revised... investigation, the Department confirmed that the proportion of Technology Training Joint Programs Staff...

  2. 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

  3. Nuclear safety training program (NSTP) for dismantling

    International Nuclear Information System (INIS)

    Cretskens, Pieter; Lenie, Koen; Mulier, Guido

    2014-01-01

    European Control Services (GDF Suez) has developed and is still developing specific training programs for the dismantling and decontamination of nuclear installations. The main topic in these programs is nuclear safety culture. We therefore do not focus on technical training but on developing the right human behavior to work in a 'safety culture' environment. The vision and techniques behind these programs have already been tested in different environments: for example the dismantling of the BN MOX Plant in Dessel (Belgium), Nuclear Safety Culture Training for Electrabel NPP Doel..., but also in the non-nuclear industry. The expertise to do so was found in combining the know-how of the Training and the Nuclear Department of ECS. In training, ECS is one of the main providers of education in risky tasks, like elevation and manipulation of charges, working in confined spaces... but it does also develop training on demand to improve safety in a certain topic. Radiation Protection is the core business in the Nuclear Department with a presence on most of the nuclear sites in Belgium. Combining these two domains in a nuclear safety training program, NSTP, is an important stage in a dismantling project due to specific contamination, technical and other risks. It increases the level of safety and leads to a harmonization of different working cultures. The modular training program makes it possible to evaluate constantly as well as in group or individually. (authors)

  4. Reading assessment and training program

    International Nuclear Information System (INIS)

    Lewis, C.L.

    1991-01-01

    The objective was to ensure ourselves and the general public that the workers in the Nuclear Materials Processing Department (NMPD) could read, follow, and understand procedures. Procedures were randomly selected and analyzed for reading levels. A tenth grade reading level was established as the standard for all NMPD employees. Employees were tested to determine reading levels and approximately 12% could not read at the target level. A Procedure Walk-Through Evaluation was administered to each person not reaching tenth grade reading level. This was a job performance measure given to ensure that the worker was competent in his/her present job, and should remain there while completing reading training. A mandatory Reading Training Program utilizing Computer Based Training was established. This program is self-paced, individualized instruction and provided to the worker on Company time. Results of the CBT Program have been very good. Instruction is supplemented with test-taking skills seminars, practice exams, individual conferences with their own reading specialist, and some self-directed study books. This paper describes the program at Savannah River Site

  5. 42 CFR 432.30 - Training programs: General requirements.

    Science.gov (United States)

    2010-10-01

    ... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE PERSONNEL ADMINISTRATION Training Programs... of the program; (2) Be related to job duties performed or to be performed by the persons trained; and (3) Be consistent with the program objectives of the agency. ...

  6. Effectiveness of the Thoracic Pedicle Screw Placement Using the Virtual Surgical Training System: A Cadaver Study.

    Science.gov (United States)

    Hou, Yang; Lin, Yanping; Shi, Jiangang; Chen, Huajiang; Yuan, Wen

    2018-03-14

    The virtual simulation surgery has initially exhibited its promising potentials in neurosurgery training. To evaluate effectiveness of the Virtual Surgical Training System (VSTS) on novice residents placing thoracic pedicle screws in a cadaver study. A total of 10 inexperienced residents participated in this study and were randomly assigned to 2 groups. The group using VSTS to learn thoracic pedicle screw fixation was the simulation training (ST) group and the group receiving an introductory teaching session was the control group. Ten fresh adult spine specimens including 6 males and 4 females with a mean age of 58.5 yr (range: 33-72) were collected and randomly allocated to the 2 groups. After exposing anatomic structures of thoracic spine, the bilateral pedicle screw placement of T6-T12 was performed on each cadaver specimen. The postoperative computed tomography scan was performed on each spine specimen, and experienced observers independently reviewed the placement of the pedicle screws to assess the incidence of pedicle breach. The screw penetration rates of the ST group (7.14%) was significantly lower in comparison to the control group (30%, P < .05). Statistically significant difference in acceptable rates of screws also occurred between the ST (100%) and control (92.86%) group (P < .05). In addition, the average screw penetration distance in control group (2.37 mm ± 0.23 mm) was significantly greater than ST group (1.23 mm ± 0.56 mm, P < .05). The virtual reality surgical training of thoracic pedicle screw instrumentation effectively improves surgical performance of novice residents compared to those with traditional teaching method, and can help new beginners to master the surgical technique within shortest period of time.

  7. Workplace Violence Training Programs for Health Care Workers: An Analysis of Program Elements.

    Science.gov (United States)

    Arbury, Sheila; Hodgson, Michael; Zankowski, Donna; Lipscomb, Jane

    2017-06-01

    Commercial workplace violence (WPV) prevention training programs differ in their approach to violence prevention and the content they present. This study reviews 12 such programs using criteria developed from training topics in the Occupational Safety and Health Administration's (OSHA) Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers and a review of the WPV literature. None of the training programs addressed all the review criteria. The most significant gap in content was the lack of attention to facility-specific risk assessment and policies. To fill this gap, health care facilities should supplement purchased training programs with specific training in organizational policies and procedures, emergency action plans, communication, facility risk assessment, and employee post-incident debriefing and monitoring. Critical to success is a dedicated program manager who understands risk assessment, facility clinical operations, and program management and evaluation.

  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. Clinical training: a simulation program for phlebotomy

    Directory of Open Access Journals (Sweden)

    Araki Toshitaka

    2008-01-01

    Full Text Available Abstract Background Basic clinical skills training in the Japanese medical education system has traditionally incorporated on-the-job training with patients. Recently, the complementary use of simulation techniques as part of this training has gained popularity. It is not known, however, whether the participants view this new type of education program favorably; nor is the impact of this program known. In this study we developed a new simulation-based training program in phlebotomy for new medical residents and assessed their satisfaction with the program Methods The education program comprised two main components: simulator exercise sessions and the actual drawing of blood from other trainees. At the end of the session, we surveyed participant sentiment regarding the program. Results There were 43 participants in total. In general, they were highly satisfied with the education program, with all survey questions receiving scores of 3 or more on a scale of 1–5 (mean range: 4.3 – 4.8, with 5 indicating the highest level of satisfaction. Additionally, their participation as a 'patient' for their co-trainees was undertaken willingly and was deemed to be a valuable experience. Conclusion We developed and tested an education program using a simulator for blood collection. We demonstrated a high satisfaction level among the participants for this unique educational program and expect that it will improve medical training, patient safety, and quality of care. The development and dissemination of similar educational programs involving simulation for other basic clinical skills will be undertaken in the future.

  10. The Efficacy of Stuttering Measurement Training: Evaluating Two Training Programs

    Science.gov (United States)

    Bainbridge, Lauren A.; Stavros, Candace; Ebrahimian, Mineh; Wang, Yuedong; Ingham, Roger J.

    2015-01-01

    Purpose: Two stuttering measurement training programs currently used for training clinicians were evaluated for their efficacy in improving the accuracy of total stuttering event counting. Method: Four groups, each with 12 randomly allocated participants, completed a pretest-posttest design training study. They were evaluated by their counts of…

  11. The safe use of surgical energy devices by surgeons may be overestimated.

    Science.gov (United States)

    Ha, Ally; Richards, Carly; Criman, Erik; Piaggione, Jillian; Yheulon, Christopher; Lim, Robert

    2018-03-01

    Surgical energy injuries are an underappreciated phenomenon. Improper use of surgical energy or poor attention to patient safety can result in operating room fires, tissue injuries, and interferences with other electronic devices, while rare complications can be devastatingly severe. Despite this, there is no current standard requirement for educating surgeons on the safe use of energy-based devices or evaluation of electrosurgery (ES) education in residency training, credentialing, or practice. The study aimed to assess the current baseline knowledge of surgeons and surgical trainees with regards to ES across varying experiences at a tertiary level care center. Surgeons and surgical trainees from seven surgical specialties (General Surgery, Cardiothoracic Surgery, Vascular Surgery, Obstetrics/Gynecology, Orthopedic Surgery, Urology, and Otorhinolaryngology) at a tertiary level care hospital were tested. Testing included an evaluation regarding their background training and experiences with ES-related adverse events and a 15 multiple-choice-question exam testing critical knowledge of ES. A total of 134 surveys were sent out with 72 responses (53.7%). The mean quiz score was 51.5 ± 15.5% (passing score was 80%). Of staff surgeons, 33/65 (50.8%) completed the survey with mean and median scores of 54.9 and 53.3%, respectively (range 33.3-86.7%). Of surgical trainees, 39/69 (56.5%) completed the survey with mean and median scores of 48.6 and 46.7%, respectively (range 13.3-80.0%). There were no statistically significant differences based on training status (p = 0.08), previous training (p = 0.24), number of cases (p = 0.06), or specialty (p = 0.689). Surgeons and surgical trainees both have a significant knowledge gap in the safe and effective use of surgical energy devices, regardless of surgical specialty and despite what they feel was adequate training. The knowledge gap is not improved with experience. A formal surgical energy education program

  12. Educational and training aspects of new surgical techniques: experience with the endoscopic–laparoscopic interdisciplinary training entity (ELITE) model in training for a natural orifice translumenal endoscopic surgery (NOTES) approach to appendectomy.

    Science.gov (United States)

    Gillen, Sonja; Gröne, Jörn; Knödgen, Fritz; Wolf, Petra; Meyer, Michael; Friess, Helmut; Buhr, Heinz-Johannes; Ritz, Jörg-Peter; Feussner, Hubertus; Lehmann, Kai S

    2012-08-01

    Natural orifice translumenal endoscopic surgery (NOTES) is a new surgical concept that requires training before it is introduced into clinical practice. The endoscopic–laparoscopic interdisciplinary training entity (ELITE) is a training model for NOTES interventions. The latest research has concentrated on new materials for organs with realistic optical and haptic characteristics and the possibility of high-frequency dissection. This study aimed to assess both the ELITE model in a surgical training course and the construct validity of a newly developed NOTES appendectomy scenario. The 70 attendees of the 2010 Practical Course for Visceral Surgery (Warnemuende, Germany) took part in the study and performed a NOTES appendectomy via a transsigmoidal access. The primary end point was the total time required for the appendectomy, including retrieval of the appendix. Subjective evaluation of the model was performed using a questionnaire. Subgroups were analyzed according to laparoscopic and endoscopic experience. The participants with endoscopic or laparoscopic experience completed the task significantly faster than the inexperienced participants (p = 0.009 and 0.019, respectively). Endoscopic experience was the strongest influencing factor, whereas laparoscopic experience had limited impact on the participants with previous endoscopic experience. As shown by the findings, 87.3% of the participants stated that the ELITE model was suitable for the NOTES training scenario, and 88.7% found the newly developed model anatomically realistic. This study was able to establish face and construct validity for the ELITE model with a large group of surgeons. The ELITE model seems to be well suited for the training of NOTES as a new surgical technique in an established gastrointestinal surgery skills course.

  13. The pregnant female surgical resident

    Directory of Open Access Journals (Sweden)

    Shifflette V

    2018-05-01

    Full Text Available Vanessa Shifflette,1 Susannah Hambright,2 Joseph Darryl Amos,1 Ernest Dunn,3 Maria Allo4 1Associates in Surgical Acute Care, Methodist Dallas Medical Center, Dallas, TX, USA; 2Methodist Surgical Associates, Methodist Dallas Medical Center, Dallas, TX, USA; 3Graduate Medical Education - General Surgery, Methodist Dallas Medical Center, Dallas, TX, USA; 4Santa Clara Valley Medical Center, San Jose, CA, USA Background: Surgery continues to be an intense, time-consuming residency. Many medical students decide against surgery as a profession due to the long work hours and family strain. The pregnant female surgical resident has an added stress factor compared to her male counterpart. Methods: We distributed an electronic, online 26-question survey to 32 general surgery programs in the southwestern region of the United States. Each program distributed our survey to the female surgical residents who had been pregnant during residency in the last 5 years. Each program was re-contacted 6 weeks after the initial contact. Most questions were in a 5-point Likert scale format. The responses were collected and analyzed using the Survey Monkey website. Results: An unvalidated survey was sent to 32 general surgery programs and 26 programs responded (81%. Each program was asked for the total number of possible responses from female residents that met our criteria (60 female residents. Seven of the programs (27% stated that they have had zero residents pregnant. We had 22 residents respond (37%. Over half of the residents (55% were pregnant during their 2nd or 3rd year of residency, with only 18% pregnant during a research year. Thirty-one percent had a lower American Board of Surgery In-Training Exam (ABSITE score. Ninety percent of the residents were able to take 4 weeks or more for maternity leave. Most of the residents (95% stated that they would do this again during residency given the opportunity, but many of the residents felt that returning back to work

  14. Catalog of Nonresident Training Courses, 1994 Edition

    Science.gov (United States)

    1994-01-01

    place of two old courses; General PHARMA CO THERAPEUTICS Oral Surgical Procedures and Exodontia; NAVPERS IN DENTAL PRACTICE 10729-A; and Special Oral...PRIVATE TUTOR - BASIC NUMBERS CONCEPTS C U G ST 5-4 SHIPBOARD TRAINING ENHANCEMENT PROGRAM INDEX OF SHIPBOARD TRAINING ENHANCEMENT PROGRAM PACKAGES...Continued) MEDIA CLASSIFICATION SUBJECT AREA TITLE FEATURES PRIVATE TUTOR - MATH COMPUTATION SKILLS C U G ST PRIVATE TUTOR - PREPARING FOR GEOMETRY AND

  15. HEALS Hypertension Control Program: Training Church Members as Program Leaders.

    Science.gov (United States)

    Dodani, Sunita; Beayler, Irmatine; Lewis, Jennifer; Sowders, Lindsey A

    2014-01-01

    Health disparities related to cardiovascular diseases (CVDs) including stroke have remained higher in the African-Americans (AAs) than in other populations. HEALS is a faith-based hypertension (HTN) control program modified according to AA community needs, and delivered by the church-lay members called church health advisors (CHAs). This study examined the feasibility and acceptability of training CHAs as HEALS program leaders. Four CHAs completed a 10-hour HEALS program training workshop at the Church, conducted by the nutrition experts. Workshop was evaluated by CHAs on their level of satisfaction, clarity of contents covered and comfort in delivery the program to the church congregation. The overall six main HEALS curriculum components were completed. Workshop was highly evaluated by CHAs on length of training, balance between content and skills development, and level of satisfaction with program delivery. Church-based culturally modified health promotion interventions conducted by the community lay members may be a way to reduce health disparities in ethnic minorities.

  16. Effective safety training program design

    International Nuclear Information System (INIS)

    Chilton, D.A.; Lombardo, G.J.; Pater, R.F.

    1991-01-01

    Changes in the oil industry require new strategies to reduce costs and retain valuable employees. Training is a potentially powerful tool for changing the culture of an organization, resulting in improved safety awareness, lower-risk behaviors and ultimately, statistical improvements. Too often, safety training falters, especially when applied to pervasive, long-standing problems. Stepping, Handling and Lifting injuries (SHL) more commonly known as back injuries and slips, trips and falls have plagued mankind throughout the ages. They are also a major problem throughout the petroleum industry. Although not as widely publicized as other immediately-fatal accidents, injuries from stepping, materials handling, and lifting are among the leading causes of employee suffering, lost time and diminished productivity throughout the industry. Traditional approaches have not turned the tide of these widespread injuries. a systematic safety training program, developed by Anadrill Schlumberger with the input of new training technology, has the potential to simultaneously reduce costs, preserve employee safety, and increase morale. This paper: reviews the components of an example safety training program, and illustrates how a systematic approach to safety training can make a positive impact on Stepping, Handling and Lifting injuries

  17. Customer satisfaction with training programs

    NARCIS (Netherlands)

    Mulder, M.

    2001-01-01

    In this contribution, a model of evaluation of customer satisfaction about training programs is described. The model is developed and implemented for an association of training companies. The evaluation has been conducted by an independent organisation to enhance the thrustworthiness of the

  18. Idaho Chemical Processing Plant training program

    International Nuclear Information System (INIS)

    1975-01-01

    Objectives, regulations and requirements, training methods, certification and recertification, progression and incentives, and coverage of the ICPP operator training program are discussed in detail. (LK)

  19. Training Programs for Managing Well-being in Companies

    Directory of Open Access Journals (Sweden)

    Treven Sonja

    2015-08-01

    Full Text Available This paper discussed the significance of well-being (WB and well-being management (WBM. As successful WBM requires the implementation of different training programs, such programs are presented in detail. The cause–effect relationship between training and individual/organizational performance is researched as well. The aim of the research to support this article was to present WBM, its training programs, as well as the determination of WBM activities concerning the mentioned programs implemented in Slovenian organizations.

  20. 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.

  1. 76 FR 35474 - UAW-Chrysler Technical Training Center, Technology Training Joint Programs Staff, Including On...

    Science.gov (United States)

    2011-06-17

    ...-Chrysler Technical Training Center, Technology Training Joint Programs Staff, Including On-Site Leased Workers From Cranks, O/E Learning, DBSI, IDEA, and Tonic/MVP, Detroit, MI; UAW-Chrysler Technical Training... workers and former workers of UAW-Chrysler Technical Training Center, Technology Training Joint Programs...

  2. NET-ZERO ENERGY BUILDING OPERATOR TRAINING PROGRAM (NZEBOT)

    Energy Technology Data Exchange (ETDEWEB)

    Brizendine, Anthony; Byars, Nan; Sleiti, Ahmad; Gehrig, Bruce; Lu, Na

    2012-12-31

    The primary objective of the Net-Zero Energy Building Operator Training Program (NZEBOT) was to develop certificate level training programs for commercial building owners, managers and operators, principally in the areas of energy / sustainability management. The expected outcome of the project was a multi-faceted mechanism for developing the skill-based competency of building operators, owners, architects/engineers, construction professionals, tenants, brokers and other interested groups in energy efficient building technologies and best practices. The training program draws heavily on DOE supported and developed materials available in the existing literature, as well as existing, modified, and newly developed curricula from the Department of Engineering Technology & Construction Management (ETCM) at the University of North Carolina at Charlotte (UNC-Charlotte). The project goal is to develop a certificate level training curriculum for commercial energy and sustainability managers and building operators that: 1) Increases the skill-based competency of building professionals in energy efficient building technologies and best practices, and 2) Increases the workforce pool of expertise in energy management and conservation techniques. The curriculum developed in this project can subsequently be used to establish a sustainable energy training program that can contribute to the creation of new “green” job opportunities in North Carolina and throughout the Southeast region, and workforce training that leads to overall reductions in commercial building energy consumption. Three energy training / education programs were developed to achieve the stated goal, namely: 1. Building Energy/Sustainability Management (BESM) Certificate Program for Building Managers and Operators (40 hours); 2. Energy Efficient Building Technologies (EEBT) Certificate Program (16 hours); and 3. Energy Efficent Buildings (EEB) Seminar (4 hours). Training Program 1 incorporates the following

  3. 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.

  4. Personal and Professional Well-Being of Surgical Residents in New England.

    Science.gov (United States)

    Yoo, Peter S; Tackett, John J; Maxfield, Mark W; Fisher, Rosemarie; Huot, Stephen J; Longo, Walter E

    2017-06-01

    Although there is increasing literature about burnout and attrition among surgeons, little is known about personal and professional well-being of surgical trainees. General surgery residents from the 6 New England states participated in a cross-sectional, qualitative, self-reported survey to assess the domains of personal health maintenance, personal finance, work environment, and fatigue management as they relate to surgical training. All surgical residency programs in the New England region were invited to participate. Of these 19 programs, 10 elected to participate in the study. Three hundred and sixty-three total trainees were contacted with requests to participate, and 166 completed responses to the survey, resulting in a response rate of 44.9%. Ninety percent of respondents identified their programs as "university or academic." Substantial cohorts reported that during training they lacked basic healthcare maintenance visits (54%) and had undesired weight gain (44%). Although most found their stipends adequate, three-quarters worried about their finances (75%) and reported substantial educational debt (45%). Most residents enjoyed coming to work; however, the vast majority reported that work-related stress is moderate to extreme (92%). Most also reported that work-related stress negatively affects their overall well-being (72%). The mean Epworth Sleepiness Scale score among respondents was 14, consistent with moderate excessive daytime sleepiness. Surgical trainee well-being is critical to optimal patient care, career development, and burnout reduction. Surgical residents attend to their own preventive health maintenance, finances, sleep, and stress reduction with variable success. Residency programs should make modest programmatic accommodations to allow trainees to tend to various aspects of their personal well-being. Copyright © 2017. Published by Elsevier Inc.

  5. Ophthalmology resident surgical competency: a national survey.

    Science.gov (United States)

    Binenbaum, Gil; Volpe, Nicholas J

    2006-07-01

    To describe the prevalence, management, and career outcomes of ophthalmology residents who struggle with surgical competency and to explore related educational issues. Fourteen-question written survey. Fifty-eight program directors at Accreditation Council on Graduate Medical Education-accredited, United States ophthalmology residency programs, representing a total of 2179 resident graduates, between 1991 and 2000. Study participants completed a mailed, anonymous survey whose format combined multiple choice and free comment questions. Number of surgically challenged residents, types of problems identified, types of remediation, final departmental decision at the end of residency, known career outcomes, and residency program use of microsurgical skills laboratories and applicant screening tests. One hundred ninety-nine residents (9% overall; 10% mean per program) were labeled as having trouble mastering surgical skills. All of the programs except 2 had encountered such residents. The most frequently cited problems were poor hand-eye coordination (24%) and poor intraoperative judgment (22%). Most programs were supportive and used educational rather than punitive measures, the most common being extra practice-laboratory time (32%), scheduling cases with the best teaching surgeon (23%), and counseling (21%). Nearly one third (31%) of residents were believed to have overcome their difficulties before graduation. Other residents were encouraged to pursue medical ophthalmology (22%) or to obtain further surgical training through a fellowship (21%) or a supervised practice setting (12%); these residents were granted a departmental statement of satisfactory completion of residency for Board eligibility. Twelve percent were asked to leave residency. Of reported career outcomes, 92% of residents were practicing ophthalmology, 65% as surgical and 27% as medical ophthalmologists. Ninety-eight percent of residency programs had microsurgical practice facilities, 64% had a formal

  6. Challenges in Measuring Benefit of Clinical Research Training Programs--the ASH Clinical Research Training Institute Example.

    Science.gov (United States)

    Sung, Lillian; Crowther, Mark; Byrd, John; Gitlin, Scott D; Basso, Joe; Burns, Linda

    2015-12-01

    The American Society of Hematology developed the Clinical Research Training Institute (CRTI) to address the lack of training in patient-oriented research among hematologists. As the program continues, we need to consider metrics for measuring the benefits of such a training program. This article addresses the benefits of clinical research training programs. The fundamental and key components are education and mentorship. However, there are several other benefits including promotion of collaboration, job and advancement opportunities, and promotion of work-life balance. The benefits of clinical research training programs need to be measured so that funders and society can judge if they are worth the investment in time and resources. Identification of elements that are important to program benefit is essential to measuring the benefit of the program as well as program planning. Future work should focus on the constructs which contribute to benefits of clinical research training programs such as CRTI.

  7. Step-by-step phacoemulsification training program for ophthalmology residents

    Directory of Open Access Journals (Sweden)

    Wang Yulan

    2013-01-01

    Full Text Available Aims: The aim was to analyze the learning curve of phacoemulsification (phaco performed by residents without experience in performing extra-capsular cataract extraction (ECCE in a step-by-step training program (SBSTP. Materials and Methods: Consecutive surgical records of phaco performed from March 2009 to Sept 2011 by four residents without previous ECCE experience were retrospectively reviewed. The completion rate of the first 30 procedures by each resident was calculated. The main intraoperative phaco parameter records for the first 30 surgeries by each resident were compared with those for their last 30 surgeries. Intraoperative complications in the residents′ procedures were also recorded and analyzed. Results: A total of 1013 surgeries were performed by residents. The completion rate for the first 30 phaco procedures was 79.2 μ 5.8%. The main reasons for halting the procedure were as follows: Anterior capsule tear, inability to crack the nucleus, and posterior capsular rupture during phaco or cortex removal. Cumulative dissipated energy of phaco power used during the surgeries was significantly less in the last 30 cases compared with the first 30 cases (30.10 μ 17.58 vs. 55.41 μ 37.59, P = 0.021. Posterior capsular rupture rate was 2.5 μ 1.2% in total (10.8 μ 4.2% in the first 30 cases and 1.7 μ 1.9% in the last 30 cases, P = 0.008; a statistically significant difference. Conclusion:The step-by-step training program might be a necessary process for a resident to transit from dependence to a self-supported operator. It is also an essential middle step between wet lab training to performing the entire phaco procedure on the patient both effectively and safely.

  8. The Rwanda Field Epidemiology and Laboratory Training Program ...

    African Journals Online (AJOL)

    The Rwanda Field Epidemiology and Laboratory Training Program (RFELTP) is a 2-year public health leadership development training program that provides applied epidemiology and public health laboratory training while the trainees provide public health service to the Ministry of Health. RFELTP is hosted at the National ...

  9. Lifelike Vascular Reperfusion of a Thiel-Embalmed Pig Model and Evaluation as a Surgical Training Tool.

    Science.gov (United States)

    Willaert, Wouter; Tozzi, Francesca; Van Hoof, Tom; Ceelen, Wim; Pattyn, Piet; D''Herde, Katharina

    2016-01-01

    Vascular reperfusion of Thiel cadavers can aid surgical and anatomical instruction. This study investigated whether ideal embalming circumstances provide lifelike vascular flow, enabling surgical practice and enhancing anatomical reality. Pressure-controlled pump-driven administration of blue embalming solution was assessed directly postmortem in a pig model (n = 4). Investigation of subsequent pump-driven vascular injection of red paraffinum perliquidum (PP) included assessment of flow parameters, intracorporeal distribution, anatomical alterations, and feasibility for surgical training. The microscopic distribution of PP was analyzed in pump-embalmed pig and gravity-embalmed human small intestines. Embalming lasted 50-105 min, and maximum arterial pressure was 65 mm Hg. During embalming, the following consecutive alterations were observed: arterial filling, organ coloration, venous perfusion, and further tissue coloration during the next weeks. Most organs were adequately preserved. PP generated low arterial pressures (drainage is a prerequisite to prevent anatomical deformation, allowing simulation of various surgeries. In pump-embalmed pig small intestines, PP flowed from artery to vein through the capillaries without extravasation. In contrast, arterioles were blocked in gravity-embalmed human tissues. In a pig model, immediate postmortem pressure-controlled pump embalming generates ideal circumstances for (micro)vascular reperfusion with PP, permitting lifelike anatomy instruction and surgical training. © 2016 S. Karger AG, Basel.

  10. Introduction of laparoscopic sacral colpopexy to a fellowship training program.

    Science.gov (United States)

    Kantartzis, Kelly; Sutkin, Gary; Winger, Dan; Wang, Li; Shepherd, Jonathan

    2013-11-01

    Minimally invasive sacral colpopexy has increased over the past decade, with many senior physicians adopting this new skill set. However, skill acquisition at an academic institution in the presence of postgraduate learners is not well described. This manuscript outlines the introduction of laparoscopic sacral colpopexy to an academic urogynecology service that was not performing minimally invasive sacral colpopexies, and it also defines a surgical learning curve. The first 180 laparoscopic sacral colpopexies done by four attending urogynecologists from January 2009 to December 2011 were retrospectively analyzed. The primary outcome was operative time. Secondary outcomes included conversion to laparotomy, estimated blood loss, and intra- and postoperative complications. Linear regression was used to analyze trends in operative times. Fisher's exact test compared surgical complications and counts of categorical variables. Mean total operative time was 250 ± 52 min (range 146-452) with hysterectomy and 222 ± 45 (range 146-353) for sacral colpopexy alone. When compared with the first ten cases performed by each surgeon, operative times in subsequent groups decreased significantly, with a 6-16.3% reduction in overall times. There was no significant difference in the rate of overall complications regardless of the number of prior procedures performed (p = 0.262). Introduction of laparoscopic sacral colpopexy in a training program is safe and efficient. Reduction in operative time is similar to published learning curves in teaching and nonteaching settings. Introducing this technique does not add additional surgical risk as these skills are acquired.

  11. Self-perceived readiness to perform at the attending level following surgical specialist training in Denmark

    DEFF Research Database (Denmark)

    Fabricius, Rasmus; Sillesen, Martin; Hansen, Morten Sejer

    2017-01-01

    not previously been studied. In the present study, we aim to investigate the role of supervision in the national surgical residency programme and the self-perceived readiness to undertake the role of a specialist doctor in gastrointestinal surgery in a cohort of gastrointestinal surgeons graduating in 2012......: A total of 30 graduated residents (55%) responded to the Danish survey. Among those, 14 (47%) felt ready to be a specialist in surgery. A total of 25 (83%) answered that increased supervision would have increased their selfperceived competencies to serve as a surgical specialist. Self -perceived readiness...... was significantly associated with level of supervision during surgical training (p = 0.02), whereas no association with operative volume could be established. CONCLUSIONS: A worryingly high number of graduates did not feel ready to undertake their role as a gastrointestinal surgical specialist. Adequate supervision...

  12. Evaluating an australian emergency nurse practitioner candidate training program.

    Science.gov (United States)

    Plath, Sharyn J; Wright, Mary; Hocking, Julia

    2017-11-01

    Nurse Practitioners (NPs) receive core clinical training at master's level, with their employer providing the opportunity to upskill in clinical and procedural competencies. It is increasingly recognised that this generic education requires supplementary training for operating effectively within a specific clinical environment. In this paper we describe a pilot program designed to train Australian NP Candidates to work effectively within the Emergency Department Fast Track model of care. The training program consisted of a 12-month period: four hours in-house training per week over two semesters, running concurrently with the NP candidate's University semesters, and 3 months' clinical practice to consolidate. The training team defined milestones for Semesters one and two, and developed a case review form to assess application of the candidate's knowledge in new clinical situations, as well as check for gaps in understanding. A clinical skills guide was developed for the candidate to work toward, and a comprehensive assessment was carried out at two time points in the training program. Feedback was obtained from the mentors and the candidate at the end point of the training program, and has been used to refine the program for 2017. This in-house training program provided specialised, evidence-based training for the emergency department environment, resulting in development of the nurse practitioner candidate as a high functioning team member. Copyright © 2017 College of Emergency Nursing Australasia. All rights reserved.

  13. Is there a place for a holistic approach in surgical training?

    Science.gov (United States)

    Atayoglu, Timucin; Buchholz, Noor; Atayoglu, Ayten Guner; Caliskan, Mujgan

    2014-03-01

    The holistic approach in medicine is a framework that considers and treats all aspects of a patient's needs, as it relates to their health. The goal of such an approach is to prevent illness, and to maximise the well-being of individuals and families. Holistic medicine is also referred to as integrative, which has been interpreted by some professionals as the combination of evidence-based medicine and complementary medicine. The speciality of Family Medicine (FM) is often referred to as General Practice (GP), a terminology which emphasises the holistic nature of that discipline. Furthermore, GP/FM professional bodies in some countries have incorporated the holistic and integrative approach into curricula and guidelines for doctors in training, which reflects its acceptance as a component of medical training. However, despite this validation, and despite research showing the effectiveness of such strategies in enhancing the outcomes of surgery, a holistic framework or integrative approach has not been equally integrated into speciality training for would-be surgeons. We argue that it would be advisable to include holistic approaches into surgical training and help surgeons to recognise their role in the continuum of care.

  14. Data Programming: Creating Large Training Sets, Quickly

    Science.gov (United States)

    Ratner, Alexander; De Sa, Christopher; Wu, Sen; Selsam, Daniel; Ré, Christopher

    2018-01-01

    Large labeled training sets are the critical building blocks of supervised learning methods and are key enablers of deep learning techniques. For some applications, creating labeled training sets is the most time-consuming and expensive part of applying machine learning. We therefore propose a paradigm for the programmatic creation of training sets called data programming in which users express weak supervision strategies or domain heuristics as labeling functions, which are programs that label subsets of the data, but that are noisy and may conflict. We show that by explicitly representing this training set labeling process as a generative model, we can “denoise” the generated training set, and establish theoretically that we can recover the parameters of these generative models in a handful of settings. We then show how to modify a discriminative loss function to make it noise-aware, and demonstrate our method over a range of discriminative models including logistic regression and LSTMs. Experimentally, on the 2014 TAC-KBP Slot Filling challenge, we show that data programming would have led to a new winning score, and also show that applying data programming to an LSTM model leads to a TAC-KBP score almost 6 F1 points over a state-of-the-art LSTM baseline (and into second place in the competition). Additionally, in initial user studies we observed that data programming may be an easier way for non-experts to create machine learning models when training data is limited or unavailable. PMID:29872252

  15. Determining the need for team-based training in delirium management: A needs assessment of surgical healthcare professionals.

    Science.gov (United States)

    Sockalingam, Sanjeev; Tehrani, Hedieh; Kacikanis, Anna; Tan, Adrienne; Hawa, Raed; Anderson, Ruthie; Okrainec, Allan; Abbey, Susan

    2015-01-01

    The high incidence of delirium in surgical units is a serious quality concern, given its impact on morbidity and mortality. While successful delirium management depends upon interdisciplinary care, training needs for surgical teams have not been studied. A needs assessment of surgical units was conducted to determine perceived comfort in managing delirium, and interprofessional training needs for team-based care. We administered a survey to 106 General Surgery healthcare professionals (69% response rate) with a focus on attitudes towards delirium and team management. Although most respondents identified delirium as important to patient outcomes, only 61% of healthcare professionals indicated that a team-based approach was always observed in practice. Less than half had a clear understanding of their role in delirium care, while just over half observed team communication of delirium care plans during handover. This is the first observation of clear gaps in perceived team performance in a General Surgery setting.

  16. Neuroscience Knowledge Among Athletic Training Professional Programs

    Directory of Open Access Journals (Sweden)

    Douglas M. Seavey

    2016-05-01

    Full Text Available The Journal of Sports Medicine & Allied Health Sciences, 2016;2(1 ISSN: 2376-9289 Seavey, Beatty, Lenhoff, & Krause. Neuroscience Knowledge Among Athletic Training Professional Programs Neuroscience Knowledge Among Athletic Training Professional Programs Douglas M. Seavey, AT, Christopher T. Beatty, Tyler L. Lenhoff, & Bentley A. Krause, PhD, AT Ohio University, College of Health Sciences & Professions, Division of Athletic Training. ____________________________________________________________________ Context: Athletic trainers (ATs, more than any other healthcare professional, has expertise in areas of on-field assessment and management of sport related concussion and spinal cord injury. A search of the key words “brain” (n=>100 or “spinal cord/spine” (n=~50 were identified in National Athletic Trainers’ Association Position Statements on Concussion and Spinal Cord Injury. However, a significant gap exists in the basic science knowledge of neuroscience and neuroanatomy. Objective: The goal of this study is to identify the basic science coursework in professional and post-professional athletic training curricula. Design and Setting: This is a descriptive, curricula analysis of CAATE Professional and Post-Professional Athletic Training Programs using web-based search and review. Participants: Curricula for accredited Professional (n=336 and Post-Professional (n=15 Athletic Training Programs were reviewed and analyzed to characteristics basic science content. Interventions: This web-based program review of CAATE standard course content and elective options occurred. Main Outcome Measures: Course titles, numbers and descriptions were accessed at CAATE.net and offerings of anatomy, gross anatomy, neuroanatomy and neuroscience, human physiology, exercise physiology, psychology, chemistry and physics content were quantified. Main outcome measures include frequencies and distributions of courses in each subject area. Results: We reviewed 309

  17. Mentoring console improves collaboration and teaching in surgical robotics.

    Science.gov (United States)

    Hanly, Eric J; Miller, Brian E; Kumar, Rajesh; Hasser, Christopher J; Coste-Maniere, Eve; Talamini, Mark A; Aurora, Alexander A; Schenkman, Noah S; Marohn, Michael R

    2006-10-01

    One of the most significant limitations of surgical robots has been their inability to allow multiple surgeons and surgeons-in-training to engage in collaborative control of robotic surgical instruments. We report the initial experience with a novel two-headed da Vinci surgical robot that has two collaborative modes: the "swap" mode allows two surgeons to simultaneously operate and actively swap control of the robot's four arms, and the "nudge" mode allows them to share control of two of the robot's arms. The utility of the mentoring console operating in its two collaborative modes was evaluated through a combination of dry laboratory exercises and animal laboratory surgery. The results from surgeon-resident collaborative performance of complex three-handed surgical tasks were compared to results from single-surgeon and single-resident performance. Statistical significance was determined using Student's t-test. Collaborative surgeon-resident swap control reduced the time to completion of complex three-handed surgical tasks by 25% compared to single-surgeon operation of a four-armed da Vinci (P nudge mode was particularly useful for guiding a resident's hands during crucially precise steps of an operation (such as proper placement of stitches). The da Vinci mentoring console greatly facilitates surgeon collaboration during robotic surgery and improves the performance of complex surgical tasks. The mentoring console has the potential to improve resident participation in surgical robotics cases, enhance resident education in surgical training programs engaged in surgical robotics, and improve patient safety during robotic surgery.

  18. 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.

  19. Talk the Talk: Implementing a Communication Curriculum for Surgical Residents.

    Science.gov (United States)

    Newcomb, Anna B; Trickey, Amber W; Porrey, Melissa; Wright, Jeffrey; Piscitani, Franco; Graling, Paula; Dort, Jonathan

    The Accreditation Council for Graduate Medical Education milestones provide a framework of specific interpersonal and communication skills that surgical trainees should aim to master. However, training and assessment of resident nontechnical skills remains challenging. We aimed to develop and implement a curriculum incorporating interactive learning principles such as group discussion and simulation-based scenarios to formalize instruction in patient-centered communication skills, and to identify best practices when building such a program. The curriculum is presented in quarterly modules over a 2-year cycle. Using our surgical simulation center for the training, we focused on proven strategies for interacting with patients and other providers. We trained and used former patients as standardized participants (SPs) in communication scenarios. Surgical simulation center in a 900-bed tertiary care hospital. Program learners were general surgery residents (postgraduate year 1-5). Trauma Survivors Network volunteers served as SPs in simulation scenarios. We identified several important lessons: (1) designing and implementing a new curriculum is a challenging process with multiple barriers and complexities; (2) several readily available facilitators can ease the implementation process; (3) with the right approach, learners, faculty, and colleagues are enthusiastic and engaged participants; (4) learners increasingly agree that communication skills can be improved with practice and appreciate the curriculum value; (5) patient SPs can be valuable members of the team; and importantly (6) the culture of patient-physician communication appears to shift with the implementation of such a curriculum. Our approach using Trauma Survivors Network volunteers as SPs could be reproduced in other institutions with similar programs. Faculty enthusiasm and support is strong, and learner participation is active. Continued focus on patient and family communication skills would enhance

  20. Comparison of two simulation systems to support robotic-assisted surgical training: a pilot study (Swine model).

    Science.gov (United States)

    Whitehurst, Sabrina V; Lockrow, Ernest G; Lendvay, Thomas S; Propst, Anthony M; Dunlow, Susan G; Rosemeyer, Christopher J; Gobern, Joseph M; White, Lee W; Skinner, Anna; Buller, Jerome L

    2015-01-01

    To compare the efficacy of simulation-based training between the Mimic dV- Trainer and traditional dry lab da Vinci robot training. A prospective randomized study analyzing the performance of 20 robotics-naive participants. Participants were enrolled in an online da Vinci Intuitive Surgical didactic training module, followed by training in use of the da Vinci standard surgical robot. Spatial ability tests were performed as well. Participants were randomly assigned to 1 of 2 training conditions: performance of 3 Fundamentals of Laparoscopic Surgery dry lab tasks using the da Vinci or performance of 4 dV-Trainer tasks. Participants in both groups performed all tasks to empirically establish proficiency criterion. Participants then performed the transfer task, a cystotomy closure using the daVinci robot on a live animal (swine) model. The performance of robotic tasks was blindly assessed by a panel of experienced surgeons using objective tracking data and using the validated Global Evaluative Assessment of Robotic Surgery (GEARS), a structured assessment tool. No statistically significant difference in surgeon performance was found between the 2 training conditions, dV-Trainer and da Vinci robot. Analysis of a 95% confidence interval for the difference in means (-0.803 to 0.543) indicated that the 2 methods are unlikely to differ to an extent that would be clinically meaningful. Based on the results of this study, a curriculum on the dV- Trainer was shown to be comparable to traditional da Vinci robot training. Therefore, we have identified that training on a virtual reality system may be an alternative to live animal training for future robotic surgeons. Published by Elsevier Inc.

  1. Nucleoelectric energy training programs in Spain

    International Nuclear Information System (INIS)

    Tanarro, A.; Izquierdo, L.

    1977-01-01

    The introduction of nucleoelectric energy in Spain is developing very rapidly. The nuclear power installed in Spain at the present time is 1,1 GWe and it is expected to increase to 8 GWe in 1980 and to 28 GWe in 1990. Spanish industry and technology are also rapidly increasing their participation in building nuclear stations, in manufacturing the necessary components and in the activities related to the nuclear fuel cycle. All of this requires properly trained personnel which is estimated at approximately 1200 high-level technicians, 1100 medium-level technicians and 1500 technical assistants by 1980. This personnel is trained: a) In engineering schools; b) In the Nuclear Studies Institute; and c) In the electric companies with nuclear programs. The majority of the high-level engineering schools in the Country include physics and basic nuclear technology courses in their programs. Some of them have an experimental low-power nuclear reactor. The Nuclear Studies Institute is an official organism depending on the Nuclear Energy Commission responsible, among other subjects, of training personnel for the peaceful use and development of nuclear energy in the Country. The electric companies also participate in training personnel for future nuclear stations and they plan to have advanced simulators of the PWR and BWR type stations for operator training. The report deals with the personnel requirement forecasts and describes the personnel training programs [es

  2. Predicting Attrition in a Military Special Program Training Command

    Science.gov (United States)

    2016-05-20

    made by assessing additional psychological factors. Specifically, motivation (s) to enter the training program (e.g., intrinsic versus extrinsic ...this and other training programs. Motivations to enter the training program could be assessed using a measure such as the Work Extrinsic and...MEDICINE GRADUATE PROGRAMS Graduate Education Office (A 1045), 4301 Jones Bridge Road, Bethesda, MD 20814 APPROVAL OF THE DOCTORAL DISSERTATION IN THE

  3. Financial impact of surgical training on hospital economics: an income analysis of 1184 out-patient clinic consultations.

    Science.gov (United States)

    Fitzgerald, J E F; Ravindra, P; Lepore, M; Armstrong, A; Bhangu, A; Maxwell-Armstrong, C A

    2013-01-01

    In many countries healthcare commissioning bodies (state or insurance-based) reimburse hospitals for their activity. The costs associated with post-graduate clinical training as part of this are poorly understood. This study quantified the financial revenue generated by surgical trainees in the out-patient clinic setting. A retrospective analysis of surgical out-patient ambulatory care appointments under 6 full-time equivalent Consultants (Attendings) in one hospital over 2 months. Clinic attendance lists were generated from the Patient Access System. Appointments were categorised as: 'new', 'review' or 'procedure' as per the Department of Health Payment by Results (PbR) Outpatient Tariff (Outpatient Treatment Function Code 104; Outpatient Procedure Code OPRSI1). During the study period 78 clinics offered 1184 appointments; 133 of these were not attended (11.2%). Of those attended 1029 had sufficient detail for analysis (98%). 261 (25.4%) patients were seen by a trainee. Applying PbR reimbursement criteria to these gave a projected annual income of £GBP 218,712 (€EU 266,527; $USD 353,657) generated by 6 surgical trainees (Residents). This is equivalent to approximately £GBP 36,452 (€EU 44,415; $USD 58,943) per trainee annually compared to £GBP 48,732 (€EU 59,378; $USD 78,800) per Consultant. This projected yearly income off-set 95% of the trainee's basic salary. Surgical trainees generated a quarter of the out-patient clinic activity related income in this study, with each trainee producing three-quarters of that generated by a Consultant. This offers considerable commercial value to hospitals. Although this must offset productivity differences and overall running costs, training bodies should ensure hospitals offer an appropriate return. In a competitive market hospitals could be invited to compete for trainees, with preference given to those providing excellence in training. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights

  4. 30 CFR 77.107-1 - Plans for training programs.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Plans for training programs. 77.107-1 Section... COAL MINES Qualified and Certified Persons § 77.107-1 Plans for training programs. Each operator must..., a program or plan setting forth what, when, how, and where the operator will train and retrain...

  5. Training within the French nuclear power program

    International Nuclear Information System (INIS)

    Jusselin, F.

    1987-01-01

    Training dispensed by the EDF Nuclear and Fossil Generation Division has contributed significantly toward successful startup and operation of French nuclear power plants. In 1986, the time-based availability of 900 MW PWRs totaled 85 %. This is just one example of how EDF training programs have benefited from 150 reactor-years of operating experience and the ensuing opportunities for perfecting and testing of training tool effectiveness. These programs have been adopted by utilities in other countries where suitable local facilities are making advantageous use of EDF training experience and methods. EDF expertise is also transferred to these countries indirectly through the simulator manufacturer

  6. Quality in-training initiative--a solution to the need for education in quality improvement: results from a survey of program directors.

    Science.gov (United States)

    Kelz, Rachel R; Sellers, Morgan M; Reinke, Caroline E; Medbery, Rachel L; Morris, Jon; Ko, Clifford

    2013-12-01

    The Next Accreditation System and the Clinical Learning Environment Review Program will emphasize practice-based learning and improvement and systems-based practice. We present the results of a survey of general surgery program directors to characterize the current state of quality improvement in graduate surgical education and introduce the Quality In-Training Initiative (QITI). In 2012, a 20-item survey was distributed to 118 surgical residency program directors from ACS NSQIP-affiliated hospitals. The survey content was developed in collaboration with the QITI to identify program director opinions regarding education in practice-based learning and improvement and systems-based practice, to investigate the status of quality improvement education in their respective programs, and to quantify the extent of resident participation in quality improvement. There was a 57% response rate. Eighty-five percent of program directors (n = 57) reported that education in quality improvement is essential to future professional work in the field of surgery. Only 28% (n = 18) of programs reported that at least 50% of their residents track and analyze their patient outcomes, compare them with norms/benchmarks/published standards, and identify opportunities to make practice improvements. Program directors recognize the importance of quality improvement efforts in surgical practice. Subpar participation in basic practice-based learning and improvement activities at the resident level reflects the need for support of these educational goals. The QITI will facilitate programmatic compliance with goals for quality improvement education. Copyright © 2013 American College of Surgeons. All rights reserved.

  7. OSHA Training Programs. Module SH-48. Safety and Health.

    Science.gov (United States)

    Center for Occupational Research and Development, Inc., Waco, TX.

    This student module on OSHA (Occupational Safety and Health Act) training programs is one of 50 modules concerned with job safety and health. This module provides a list of OSHA training requirements and describes OSHA training programs and other safety organizations' programs. Following the introduction, 11 objectives (each keyed to a page in the…

  8. Application to graduate psychology programs by undergraduate students of color: the impact of a research training program.

    Science.gov (United States)

    Hall, Gordon C Nagayama; Allard, Carolyn B

    2009-07-01

    The top 86 students were selected from a pool of approximately 400 applicants to a summer clinical psychology research training program for undergraduate students of color. Forty-three of the students were randomly assigned to 1 of 2 clinical psychology research training programs, and 43 were randomly assigned to a control condition without training. The multicultural version of the training program emphasized the cultural context of psychology in all areas of training, whereas cultural context was de-emphasized in the monocultural version of the program. Although the cultural content of the 2 training programs was effectively manipulated as indicated by a fidelity check by an outside expert, there were no significant differences between the effects of the 2 programs on the outcomes measured in this study. The primary differences in this study were between students who did versus those who did not participate in a training program. Sixty-five percent of the students who completed the multicultural training program applied to graduate schools in psychology, compared with 47% of those who completed the monocultural training program, and 31% of those in the control group. Participation in summer research training programs also increased self-perceptions of multicultural competence.

  9. Quality assurance in postgraduate pathology training the Dutch way: regular assessment, monitoring of training programs but no end of training examination.

    Science.gov (United States)

    van der Valk, Paul

    2016-01-01

    It might seem self-evident that in the transition from a supervised trainee to an independent professional who is no longer supervised, formal assessment of whether the trainee knows his/her trade well enough to function independently is necessary. This would then constitute an end of training examination. Such examinations are practiced in several countries but a rather heterogeneous situation exists in the EU countries. In the Netherlands, the training program is not concluded by a summative examination and reasons behind this situation are discussed. Quality assurance of postgraduate medical training in the Netherlands has been developed along two tracks: (1) not a single testing moment but continuous evaluation of the performance of the trainee in 'real time' situations and (2) monitoring of the quality of the offered training program through regular site-visits. Regular (monthly and/or yearly) evaluations should be part of every self-respecting training program. In the Netherlands, these evaluations are formative only: their intention is to provide the trainee a tool by which he or she can see whether they are on track with their training schedule. In the system in the Netherlands, regular site-visits to training programs constitute a crucial element of quality assurance of postgraduate training. During the site-visit, the position and perceptions of the trainee are key elements. The perception by the trainee of the training program, the institution (or department) offering the training program, and the professionals involved in the training program is explicitly solicited and systematically assessed. With this two-tiered approach high-quality postgraduate training is assured without the need for an end of training examination.

  10. Training Program in Biostatistics for Breast Cancer Research

    National Research Council Canada - National Science Library

    Little, Roderick

    1998-01-01

    The current training program terminates in the summer of 1998. We had originally planned to develop a training program in biostatistics for cancer research for submission to the National Cancer Institute (Task 9...

  11. The medical mission and modern cultural competency training.

    Science.gov (United States)

    Campbell, Alex; Sullivan, Maura; Sherman, Randy; Magee, William P

    2011-01-01

    Culture has increasingly appreciated clinical consequences on the patient-physician relationship, and governing bodies of medical education are widely expanding educational programs to train providers in culturally competent care. A recent study demonstrated the value an international surgical mission in modern surgical training, while fulfilling the mandate of educational growth through six core competencies. This report further examines the impact of international volunteerism on surgical residents, and demonstrates that such experiences are particularly suited to education in cultural competency. Twenty-one resident physicians who participated in the inaugural Operation Smile Regan Fellowship were surveyed one year after their experiences. One hundred percent strongly agreed that participation in an international surgical mission was a quality educational experience and 94.7% deemed the experience a valuable part of their residency training. In additional to education in each of the ACGME core competencies, results demonstrate valuable training in cultural competence. A properly structured and proctored experience for surgical residents in international volunteerism is an effective instruction tool in the modern competency-based residency curriculum. These endeavors provide a unique understanding of the global burden of surgical disease, a deeper appreciation for global public health issues, and increased cultural sensitivity. A surgical mission experience should be widely available to surgery residents. Copyright © 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Cardiothoracic surgical experience in Ghana.

    Science.gov (United States)

    Tettey, Mark; Tamatey, Martin; Edwin, Frank

    2016-10-01

    Ghana is one of the few low-to-middle-income countries in sub-Saharan Africa able to consistently sustain a cardiothoracic program with locally trained staff for more than two decades. Cardiothoracic surgery practice in Ghana started in 1964 but faltered from a combination of political and the economic problems. In 1989, Dr. Kwabena Frimpong-Boateng, a Ghanaian cardiothoracic surgeon trained in Hannover, rekindled interest in cardiothoracic surgery and in establishing a National Cardiothoracic Centre. His vision and leadership has brought cardiothoracic surgery practice in Ghana to its current high level. As a result, the medical landscape of what is achievable locally in both pediatric and adult patients has changed substantially: outbound medical travel that used to be common among Ghanaian cardiovascular patients has been reduced drastically. Ghana's National Cardiothoracic Center (NCTC), the only tertiary center in the country for cardiothoracic surgical pathology manages all such patients that were previously referred abroad. The NCTC has become a medical/surgical hub in the West African sub-region providing service, training, and research opportunities to neighboring countries. The Centre is accredited by the West African College of Surgeons as a center of excellence for training specialists in cardiothoracic surgery. Expectedly, practicing cardiothoracic surgery in such a resource-poor setting has peculiar challenges. This review focuses on the history, practice, successes, and challenges of cardiovascular and thoracic surgery in Ghana.

  13. ARL/OMS Consultant Training Program.

    Science.gov (United States)

    Euster, Joanne R.

    1982-01-01

    Describes Academic Library Consultant Training Program begun in 1979, sponsored by Office of Management Studies (OMS) and designed to provide 80 consultants to aid academic libraries in improving performance. Viewpoints are included from OMS Director and participants concerning program objectives, trainee selection, workshops, internships, and the…

  14. Integrated initial training program for a CEGB operations engineer

    International Nuclear Information System (INIS)

    Tompsett, P.A.

    1987-01-01

    This paper considers the overall training programs undertaken by a newly appointed Operations Engineer at one of the Central Electricity Generating Board's (CEGB) Advanced Gas Cooled Reactor (AGR) nuclear power stations. The training program is designed to equip him with the skills and knowledge necessary for him to discharge his duties safely and effectively. In order to assist the learning process and achieve and integrated program, aspects of reactor technology and operation, initially the subject of theoretical presentations at the CEGB's Nuclear Power Training Center (NPTC) are reinforced by either simulation and/or practical experience on site. In the later stages plant-specific simulators, operated by trained tutors, are incorporated into the training program to provide the trainee with practical experience of plant operation. The trainee's performance is assessed throughout the program to provide feedback to the trainee, the trainers and station management

  15. Study on Nuclear Facility Cyber Security Awareness and Training Programs

    International Nuclear Information System (INIS)

    Lee, Jung-Woon; Song, Jae-Gu; Lee, Cheol-Kwon

    2016-01-01

    Cyber security awareness and training, which is a part of operational security controls, is defined to be implemented later in the CSP implementation schedule. However, cyber security awareness and training is a prerequisite for the appropriate implementation of a cyber security program. When considering the current situation in which it is just started to define cyber security activities and to assign personnel who has responsibilities for performing those activities, a cyber security awareness program is necessary to enhance cyber security culture for the facility personnel to participate positively in cyber security activities. Also before the implementation of stepwise CSP, suitable education and training should be provided to both cyber security teams (CST) and facility personnel who should participate in the implementation. Since such importance and urgency of cyber security awareness and training is underestimated at present, the types, trainees, contents, and development strategies of cyber security awareness and training programs are studied to help Korean nuclear facilities to perform cyber security activities more effectively. Cyber security awareness and training programs should be developed ahead of the implementation of CSP. In this study, through the analysis of requirements in the regulatory standard RS-015, the types and trainees of overall cyber security training programs in nuclear facilities are identified. Contents suitable for a cyber security awareness program and a technical training program are derived. It is suggested to develop stepwise the program contents in accordance with the development of policies, guides, and procedures as parts of the facility cyber security program. Since any training programs are not available for the specialized cyber security training in nuclear facilities, a long-term development plan is necessary. As alternatives for the time being, several cyber security training courses for industrial control systems by

  16. Study on Nuclear Facility Cyber Security Awareness and Training Programs

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung-Woon; Song, Jae-Gu; Lee, Cheol-Kwon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2016-10-15

    Cyber security awareness and training, which is a part of operational security controls, is defined to be implemented later in the CSP implementation schedule. However, cyber security awareness and training is a prerequisite for the appropriate implementation of a cyber security program. When considering the current situation in which it is just started to define cyber security activities and to assign personnel who has responsibilities for performing those activities, a cyber security awareness program is necessary to enhance cyber security culture for the facility personnel to participate positively in cyber security activities. Also before the implementation of stepwise CSP, suitable education and training should be provided to both cyber security teams (CST) and facility personnel who should participate in the implementation. Since such importance and urgency of cyber security awareness and training is underestimated at present, the types, trainees, contents, and development strategies of cyber security awareness and training programs are studied to help Korean nuclear facilities to perform cyber security activities more effectively. Cyber security awareness and training programs should be developed ahead of the implementation of CSP. In this study, through the analysis of requirements in the regulatory standard RS-015, the types and trainees of overall cyber security training programs in nuclear facilities are identified. Contents suitable for a cyber security awareness program and a technical training program are derived. It is suggested to develop stepwise the program contents in accordance with the development of policies, guides, and procedures as parts of the facility cyber security program. Since any training programs are not available for the specialized cyber security training in nuclear facilities, a long-term development plan is necessary. As alternatives for the time being, several cyber security training courses for industrial control systems by

  17. Experimental evaluation of training accelerators for surgical drilling

    Directory of Open Access Journals (Sweden)

    Gosselin Florian

    2011-12-01

    Full Text Available In some specific maxillo-facial surgeries, like the Epker, the cortical part of the lower maxilla must be drilled with minimum penetration into the spongy bone to avoid the trigeminal nerve. The result of the surgery is highly dependent on the quality of the drill. Drilling must therefore be mastered by students before acting as surgeon. The study compares the efficiency of two punctual drilling training programs developed on a virtual reality platform with non medical participants. The results show better benefit of training on relevant haptic aspects of the task before introducing multimodal drilling over repeated multimodal simulated drilling exercises.

  18. System for the quality assurance of personnel training programs

    International Nuclear Information System (INIS)

    Rjona, Orison; Venegas, Maria del C.; Rodriguez, Lazaro; Lopez, Miguel A.; Armenteros, Ana L.

    1999-01-01

    In this work are described the fundamental possibilities and characteristics of a software that allows to carry out the management and automatic evaluation of all data gotten during jobs analysis and design, development, implementation and evaluation of personnel training programs of nuclear and radioactive installations and risk industries. The system that is introduced, GESAT, proportion a tool of centralized managerial control of training data and the obtaining of the quality objectives of each installation in the training of their personnel. GESAT includes all phases of SAT method (Systematic Approach to Training). It constitutes the necessary practical support for the elaboration, implementation and evaluation of training programs, allowing the establishment of restrictions and controls and avoiding inconsistencies in the process. It offers the possibility of automatic evaluation that identify fundamental deficiencies in the planning and implementation of training programs. This evaluation facilitates the systematic feed back and the continuous improvement of the training programs.(author)

  19. 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.

  20. General Electric's training program for BWR chemists

    International Nuclear Information System (INIS)

    Osborn, R.N.; Lim, W.

    1981-01-01

    This paper describes the development and implementation of the General Electric boiling water reactor chemistry training program from 1959 to the present. The original intention of this program was to provide practical hands on type training in radiochemistry to BWR chemistry supervisors with fossil station experience. This emphasis on radiochemistry has not changed through the years, but the training has expanded to include the high purity water chemistry of the BWR and has been modified to include new commission requirements, engineering developments and advanced instrumentation. Student and instructor qualifications are discussed and a description of the spin off courses for chemistry technicians and refresher training is presented

  1. Surgical case volume in Canadian urology residency: a comparison of trends in open and minimally invasive surgical experience.

    Science.gov (United States)

    Mamut, Adiel E; Afshar, Kourosh; Mickelson, Jennifer J; Macneily, Andrew E

    2011-06-01

    The application of minimally invasive surgery (MIS) has become increasingly common in urology training programs and clinical practice. Our objective was to review surgical case data from all 12 Canadian residency programs to identify trends in resident exposure to MIS and open procedures. Every year, beginning in 2003, an average of 41 postgraduate year 3 to 5 residents reported surgical case data to a secure internet relational database. Data were anonymized and extracted for the period 2003 to 2009 by measuring a set of 11 predefined index cases that could be performed in both an open and MIS fashion. 16,687 index cases were recorded by a total of 198 residents. As a proportion, there was a significant increase in MIS from 12% in 2003 to 2004 to 32% in 2008 to 2009 (P=0.01). A significant decrease in the proportion of index cases performed with an open approach was also observed from 88% in 2003 to 2004 to 68% in 2008 to 2009 (P=0.01). The majority of these shifts were secondary to the increased application of MIS for nephrectomies of all type (29%-45%), nephroureterectomy (27%-76%), adrenalectomy (15%-71%), and pyeloplasty (17%-54%) (Pfashion during the study period. MIS constitutes an increasingly significant component of surgical volume in Canadian urology residencies with a reciprocal decrease in exposure to open surgery. These trends necessitate ongoing evaluation to maintain the integrity of postgraduate urologic training.

  2. Impact of surgeon subspecialty training on surgical outcomes in open globe injuries

    Directory of Open Access Journals (Sweden)

    Han IC

    2015-09-01

    Full Text Available Ian C Han,1 Sidharth Puri,1 Jiangxia Wang,2 Shameema Sikder1 1Wilmer Eye Institute, Johns Hopkins University School of Medicine, 2Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA Purpose: The purpose of this study was to evaluate whether subspecialty training of the initial treating surgeon affects visual acuity and surgical outcomes in patients with open globe injuries.Design: This study is a single-institution, retrospective case series.Methods: The charts of adult patients with open globe injuries requiring surgical repair at the Wilmer Eye Institute between July 1, 2007 and July 1, 2012 were retrospectively reviewed. Clinical findings at presentation were recorded, and details of initial repair and follow-up surgeries were analyzed. Differences in visual acuity and surgical outcomes were compared based on subspecialty training of the initial surgeon.Results: The charts of 282 adult patients were analyzed, and 193 eyes had at least 6 months of follow-up for analysis. Eighty-six eyes (44.6% required follow-up surgery within the first year, and 39 eyes (20.2% were enucleated. Eyes initially treated by a vitreoretinal (VR surgeon were 2.3 times (P=0.003 more likely to improve by one Ocular Trauma Score (OTS visual acuity category and 1.9 times (P=0.027 more likely to have at least one more follow-up surgery at 6 months compared to eyes treated by non-VR surgeons. Patients with more anterior injuries treated by a VR surgeon were more likely to improve by one OTS visual acuity category compared to those treated by non-VR surgeons (P=0.004 and 0.016 for Zones I and II, respectively. There was no difference in visual acuity outcomes for eyes with posterior injuries (P=0.515 for Zone III.Conclusion: Eyes initially treated by a VR surgeon are more likely to improve by one OTS visual acuity category than those initially treated by a non-VR surgeon. However, patients initially treated by a VR surgeon also undergo more

  3. 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

  4. 30 CFR 75.161 - Plans for training programs.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Plans for training programs. 75.161 Section 75... Provision] § 75.161 Plans for training programs. Each operator must submit to the district manager, of the Coal Mine Safety and Health District in which the mine is located, a program or plan setting forth what...

  5. 45 CFR 235.62 - State plan requirements for training programs.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false State plan requirements for training programs. 235... ADMINISTRATION OF FINANCIAL ASSISTANCE PROGRAMS § 235.62 State plan requirements for training programs. A State plan under title I, IV-A, X, XIV, or XVI (AABD) of the Act must provide for a training program for...

  6. Robotics Programs: Automation Training in Disguise.

    Science.gov (United States)

    Rehg, James A.

    1985-01-01

    Questions and answers from the book "Guidelines for Robotics Program Development" are presented, addressing some of the major issues confronted by the person setting the direction for a robotics training program. (CT)

  7. Quality Assurance Plan for Transportation Management Division Transportation Training Programs

    International Nuclear Information System (INIS)

    1994-10-01

    The U.S. Department of Transportation (DOT) implemented new rules requiring minimum levels of training for certain key individuals who handle, package, transport, or otherwise prepare hazardous materials for transportation. In response to these rules, the U.S. Department of Energy (DOE), Transportation Management Division (TMD), has developed a transportation safety training program. This program supplies designed instructional methodology and course materials to provide basic levels of DOT training to personnel for whom training has become mandatory. In addition, this program provides advanced hazardous waste and radioactive material packaging and transportation training to help personnel achieve proficiency and/or certification as hazardous waste and radioactive material shippers. This training program does not include site-specific or task-specific training beyond DOT requirements

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

    Directory of Open Access Journals (Sweden)

    April eJohnson

    2015-10-01

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

  9. A new training model for robot-assisted urethrovesical anastomosis and posterior muscle-fascial reconstruction: the Verona training technique.

    Science.gov (United States)

    Cacciamani, G; De Marco, V; Siracusano, S; De Marchi, D; Bizzotto, L; Cerruto, M A; Motton, G; Porcaro, A B; Artibani, W

    2017-06-01

    A training model is usually needed to teach robotic surgical technique successfully. In this way, an ideal training model should mimic as much as possible the "in vivo" procedure and allow several consecutive surgical simulations. The goal of this study was to create a "wet lab" model suitable for RARP training programs, providing the simulation of the posterior fascial reconstruction. The second aim was to compare the original "Venezuelan" chicken model described by Sotelo to our training model. Our training model consists of performing an anastomosis, reproducing the surgical procedure in "vivo" as in RARP, between proventriculus and the proximal portion of the esophagus. A posterior fascial reconstruction simulating Rocco's stitch is performed between the tissues located under the posterior surface of the esophagus and the tissue represented by the serosa of the proventriculus. From 2014 to 2015, during 6 different full-immersion training courses, thirty-four surgeons performed the urethrovesical anastomosis using our model and the Sotelo's one. After the training period, each surgeon was asked to fill out a non-validated questionnaire to perform an evaluation of the differences between the two training models. Our model was judged the best model, in terms of similarity with urethral tissue and similarity with the anatomic unit urethra-pelvic wall. Our training model as reported by all trainees is easily reproducible and anatomically comparable with the urethrovesical anastomosis as performed during radical prostatectomy in humans. It is suitable for performing posterior fascial reconstruction reported by Rocco. In this context, our surgical training model could be routinely proposed in all robotic training courses to develop specific expertise in urethrovesical anastomosis with the reproducibility of the Rocco stitch.

  10. Surgical experts: born or made?

    Science.gov (United States)

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

    2013-01-01

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

  11. How to Train Safe Drivers: Setting Up and Evaluating a Fatigue Training Program

    Directory of Open Access Journals (Sweden)

    Adamos Giannis

    2015-02-01

    Full Text Available Fatigue is considered as a serious risk driving behavior, causing road accidents, which in many cases involve fatalities and severe injuries. According to CARE database statistics, professional drivers are indicated as a high-risk group to be involved in a fatigue-related accident. Acknowledging these statistics, a training program on driving fatigue was organized, aiming at raising awareness of professional drivers of a leading company in building materials, in Greece. Selected experimental methods were used for collecting data before and after the training program, which allowed monitoring and assessing the potential behavioural changes. A questionnaire survey was conducted before the program implementation to 162 drivers of the company, while two months after the program, the same drivers replied to a second questionnaire. Impact assessment of the program relied on statistical analysis of the responses. Results showed the degree of penetration of the training program in the professional drivers' behavior towards safe driving.

  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. No Correlation Between Work-Hours and Operative Volumes--A Comparison Between United States and Danish Operative Volumes Achieved During Surgical Residency.

    Science.gov (United States)

    Kjærgaard, Jane; Sillesen, Martin; Beier-Holgersen, Randi

    2016-01-01

    Since 2003, United States residents have been limited to an 80-hour workweek. This has prompted concerns of reduced educational quality, especially inadequate operating exposure. In contrast, the Danish surgical specialty-training program mandates a cap on working hours of 37 per week. We hypothesize that there is no direct correlation between work-hours and operative volume achieved during surgical residency. To test the hypothesis, we compare Danish and US operative volumes achieved during surgical residency training. Retrospective comparative study. The data from the US population was extracted from the Accreditation Council for Graduate Medical Education database for General Surgery residents from 2012 to 2013. For Danish residents, a questionnaire with case categories matching the Accreditation Council for Graduate Medical Education categories were sent to all Danish surgeons graduating the national surgical residency program in 2012 or 2013, 54 in total. In all, 30 graduated residents (55%) responded to the Danish survey. We found no significant differences in mean total major procedures (1002.4 vs 976.9, p = 0.28) performed during residency training, but comparing average major procedures per year, the US residents achieve significantly more (132.3 vs 195.4, p work-hours and operative volumes achievable. Factors other than work-hours seem to effect on operative volumes achieved during training. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  14. Improving access to surgery in a developing country: experience from a surgical collaboration in Sierra Leone.

    Science.gov (United States)

    Kushner, Adam L; Kamara, Thaim B; Groen, Reinou S; Fadlu-Deen, Betsy D; Doah, Kisito S; Kingham, T Peter

    2010-01-01

    Although surgery is increasingly recognized as an essential component of primary health care, there has been little documentation of surgical programs in low- and middle-income countries. Surgeons OverSeas (SOS) is a New York-based organization with a mission to save lives in developing countries by improving surgical care. This article highlights the surgical program in Sierra Leone as a possible model to improve access to surgery. An SOS team conducted a needs assessment of surgical capacity in Sierra Leone in February 2008. Interventions were then developed and programs were implemented. A follow-up assessment was conducted in December 2009, which included interviews of key Sierra Leone hospital personnel and a review of operating room log books. Based on an initial needs assessment, a program was developed that included training, salary support, and the provision of surgical supplies and equipment. Two 3-day workshops were conducted for a total of 44 health workers, salary support given to over 100 staff, and 2 containers of supplies and equipment were donated. Access to surgery, as measured by the number of major operations at Connaught Hospital, increased from 460 cases in 2007 to 768 cases in 2009. The SOS program in Sierra Leone highlights a method for improving access to surgery that incorporates an initial needs assessment with minimal external support and local staff collaboration. The program functions as a catalyst by providing training, salary support, and supplies. The beneficial results of the program can then be used to advocate for additional resources for surgery from policy makers. This model could be beneficial in other resource-poor countries in which improved access to surgery is desired. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  15. A Proficiency Based Stepwise Endovascular Curricular Training (PROSPECT) Program Enhances Operative Performance in Real Life: A Randomised Controlled Trial.

    Science.gov (United States)

    Maertens, H; Aggarwal, R; Moreels, N; Vermassen, F; Van Herzeele, I

    2017-09-01

    Healthcare evolution requires optimisation of surgical training to provide safe patient care. Operating room performance after completion of proficiency based training in vascular surgery has not been investigated. A randomised controlled trial evaluated the impact of a Proficiency based Stepwise Endovascular Curricular Training program (PROSPECT) on the acquisition of endovascular skills and the transferability of these skills to real life interventions. All subjects performed two endovascular interventions treating patients with symptomatic iliac and/or superficial femoral artery stenosis under supervision. Primary outcomes were technical performances (Global Rating Scale [GRS]; Examiner Checklist), operative metrics, and patient outcomes, adjusted for case difficulty and trainee experience. Secondary outcomes included knowledge and technical performance after 6 weeks and 3 months. Thirty-two general surgical trainees were randomised into three groups. Besides traditional training, the first group (n = 11) received e-learning and simulation training (PROSPECT), the second group (n = 10) only had access to e-learning, while controls (n = 11) did not receive supplementary training. Twenty-nine trainees (3 dropouts) performed 58 procedures. Trainees who completed PROSPECT showed superior technical performance (GRS 39.36 ± 2.05; Checklist 63.51 ± 3.18) in real life with significantly fewer supervisor takeovers compared with trainees receiving e-learning alone (GRS 28.42 ± 2.15; p = .001; Checklist 53.63 ± 3.34; p = .027) or traditional education (GRS 23.09 ± 2.18; p = .001; Checklist 38.72 ± 3.38; p = .001). Supervisors felt more confident in allowing PROSPECT trained physicians to perform basic (p = .006) and complex (p = .003) procedures. No differences were detected in procedural parameters (such as fluoroscopy time, DAP, procedure time, etc.) or complications. Proficiency levels were maintained up to 3 months. A structured

  16. Radiation monitor training program at Rocky Flats

    International Nuclear Information System (INIS)

    Medina, L.C.; Kittinger, W.D.; Vogel, R.M.

    The Rocky Flats Radiation Monitor Training Program is tailored to train new health physics personnel in the field of radiation monitoring. The purpose of the prescribed materials and media is to be consistent in training in all areas of Rocky Flats radiation monitoring job involvement

  17. Virtual reality simulator training of laparoscopic cholecystectomies - a systematic review.

    Science.gov (United States)

    Ikonen, T S; Antikainen, T; Silvennoinen, M; Isojärvi, J; Mäkinen, E; Scheinin, T M

    2012-01-01

    Simulators are widely used in occupations where practice in authentic environments would involve high human or economic risks. Surgical procedures can be simulated by increasingly complex and expensive techniques. This review gives an update on computer-based virtual reality (VR) simulators in training for laparoscopic cholecystectomies. From leading databases (Medline, Cochrane, Embase), randomised or controlled trials and the latest systematic reviews were systematically searched and reviewed. Twelve randomised trials involving simulators were identified and analysed, as well as four controlled studies. Furthermore, seven studies comparing black boxes and simulators were included. The results indicated any kind of simulator training (black box, VR) to be beneficial at novice level. After VR training, novice surgeons seemed to be able to perform their first live cholecystectomies with fewer errors, and in one trial the positive effect remained during the first ten cholecystectomies. No clinical follow-up data were found. Optimal learning requires skills training to be conducted as part of a systematic training program. No data on the cost-benefit of simulators were found, the price of a VR simulator begins at EUR 60 000. Theoretical background to learning and limited research data support the use of simulators in the early phases of surgical training. The cost of buying and using simulators is justified if the risk of injuries and complications to patients can be reduced. Developing surgical skills requires repeated training. In order to achieve optimal learning a validated training program is needed.

  18. 30 CFR 77.1706 - First aid training program; minimum requirements.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false First aid training program; minimum... OF UNDERGROUND COAL MINES Miscellaneous § 77.1706 First aid training program; minimum requirements. (a) All first aid training programs required under the provisions of §§ 77.1703 and 77.1704 shall...

  19. 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.

  20. The manpower training and development programs of NUCLEBRAS for the Brazilian nuclear program

    International Nuclear Information System (INIS)

    Spitalnik, J.; Lerner Neto, C.; Stilben, V.; Botelho, O.

    1984-01-01

    As technology transfer is one of the main objectives of the Brazilian Nuclear Program, the principal aim of manpower training has been to provide the conditions for absorbing this technology. The strategy used for such a program required a quantitative and qualitative planning of manpower needs, through medium-range and long-term forecasts, with the condition of maximum utilization of the existing educational infra-structure. On-the-job training which is considered one of the most important means for technology transfer, was given highest priority. Also, management development was considered very important for the implementation of the Nuclear Program. This paper shows the results achieved from 1973 up to now by the manpower training and development programs. (Author) [pt

  1. Radiation protection technologist training and certification program

    International Nuclear Information System (INIS)

    1982-10-01

    The purpose of this program is to establish training requirements and methods for certifying the technical competence of Radiation Protection Technologists. This manual delineates general requirements as well as academic training, on-the-job training, area of facility training, and examination or evaluation requirements for Radiation Protection Trainees (Trainees), Junior Radiation Protection Technologists (JRPT), Radiation Protection Technologists (RPT), and Senior Radiation Protection Technologists (SRPT). This document also includes recertification requirements for SRPTs. The appendices include training course outlines, on-the-job training outlines, and training certification record forms

  2. Enrollment of SME Managers to Growth-oriented Training Programs

    DEFF Research Database (Denmark)

    Bager, Torben; Jensen, Kent Wickstrøm; Schou Nielsen, Pia

    2015-01-01

    Purpose: Entrepreneurial learning through formal growth-oriented training programs for SME managers promises to enhance the growth competences and growth intentions of the enrolled managers. The impact of such programs, however, depends on who enrolls since initial competence and growth-intention......Purpose: Entrepreneurial learning through formal growth-oriented training programs for SME managers promises to enhance the growth competences and growth intentions of the enrolled managers. The impact of such programs, however, depends on who enrolls since initial competence and growth...... has from 2012 to 2015 trained about 700 SME managers. Data are currently available for 366 of these participants. This evidence is compared with survey results from a randomly selected control group of 292 growth oriented SME managers in the same firm-size group. The data were analyzed through...... of the program. Originality/value The paper is the first systematic study of the importance of who enrolls in training programs for SME managers....

  3. Directory of Instructional Programs in Supervision and Management Training.

    Science.gov (United States)

    Civil Service Commission, Washington, DC. Training Assistance Div.

    This directory, which is designed for the use of training officers in the Washington, D.C. area in prescribing learning programs to meet employee training needs, describes available group and self instructional programs used for the training of supervisors and managers. Each of the 21 courses listed contains the pertinent information necessary to…

  4. Investing in a Surgical Outcomes Auditing System

    Science.gov (United States)

    Bermudez, Luis; Trost, Kristen; Ayala, Ruben

    2013-01-01

    Background. Humanitarian surgical organizations consider both quantity of patients receiving care and quality of the care provided as a measure of success. However, organizational efficacy is often judged by the percent of resources spent towards direct intervention/surgery, which may discourage investment in an outcomes monitoring system. Operation Smile's established Global Standards of Care mandate minimum patient followup and quality of care. Purpose. To determine whether investment of resources in an outcomes monitoring system is necessary and effectively measures success. Methods. This paper analyzes the quantity and completeness of data collected over the past four years and compares it against changes in personnel and resources assigned to the program. Operation Smile began investing in multiple resources to obtain the missing data necessary to potentially implement a global Surgical Outcomes Auditing System. Existing personnel resources were restructured to focus on postoperative program implementation, data acquisition and compilation, and training materials used to educate local foundation and international employees. Results. An increase in the number of postoperative forms and amount of data being submitted to headquarters occurred. Conclusions. Humanitarian surgical organizations would benefit from investment in a surgical outcomes monitoring system in order to demonstrate success and to ameliorate quality of care. PMID:23401763

  5. Why do seniors leave resistance training programs?

    Directory of Open Access Journals (Sweden)

    Burton E

    2017-03-01

    Full Text Available Elissa Burton,1 Anne-Marie Hill,1 Simone Pettigrew,2 Gill Lewin,3 Liz Bainbridge,1 Kaela Farrier,1 Phil Airey,4 Keith D Hill1 1School of Physiotherapy and Exercise Science, 2School of Psychology and Speech Pathology, 3School of Nursing, Midwifery and Paramedicine, Curtin University, 4Council on the Ageing, Perth, WA, Australia Purpose: The proportion of the population, that is older, is growing at a faster rate than other age groups. Physical activity is important for older people because it assists in living independently. Participating in resistance training on a regular basis (twice weekly is recommended for older people; yet, fewer than 15% of people over 60 years achieve this level. The aim of this article was to investigate the factors contributing to older people’s decisions to stop participation in a resistance training program.Participants and methods: Participants were older people who had chosen to participate in a structured resistance training program specifically designed for seniors and then after a period of time discontinued. This population received a questionnaire in the mail focused on factors contributing to their cessation of resistance training exercise. Qualitative results were analyzed using inductive content analysis.Results: Fifty-six survey responses were received (average age 71.5 years, SD =9.0; 79% females. Injury, illness, and holidaying were the main reasons for ceasing participation. A small but important number of responses (11% reported that they considered they were not provided with sufficient support during the resistance training programs.Conclusions: To attract and retain their senior clients, the results indicate that program organizers need to provide tailored support to return to resistance training after injury and offer flexible and individualized services that accommodate older people’s life choices in retirement. Keywords: older people, strength training, gymnasium, retention, aging

  6. Frustrations among graduates of athletic training education programs.

    Science.gov (United States)

    Bowman, Thomas G; Dodge, Thomas M

    2013-01-01

    Although previous researchers have begun to identify sources of athletic training student stress, the specific reasons for student frustrations are not yet fully understood. It is important for athletic training administrators to understand sources of student frustration to provide a supportive learning environment. To determine the factors that lead to feelings of frustration while completing a professional athletic training education program (ATEP). Qualitative study. National Athletic Trainers' Association (NATA) accredited postprofessional education program. Fourteen successful graduates (12 women, 2 men) of accredited professional undergraduate ATEPs enrolled in an NATA-accredited postprofessional education program. We conducted semistructured interviews and analyzed data with a grounded theory approach using open, axial, and selective coding procedures. We negotiated over the coding scheme and performed peer debriefings and member checks to ensure trustworthiness of the results. Four themes emerged from the data: (1) Athletic training student frustrations appear to stem from the amount of stress involved in completing an ATEP, leading to anxiety and feelings of being overwhelmed. (2) The interactions students have with classmates, faculty, and preceptors can also be a source of frustration for athletic training students. (3) Monotonous clinical experiences often left students feeling disengaged. (4) Students questioned entering the athletic training profession because of the fear of work-life balance problems and low compensation. In order to reduce frustration, athletic training education programs should validate students' decisions to pursue athletic training and validate their contributions to the ATEP; provide clinical education experiences with graded autonomy; encourage positive personal interactions between students, faculty, and preceptors; and successfully model the benefits of a career in athletic training.

  7. See me, touch me, heal me : the role of visuo-spatial ability in virtual anatomical learning and surgical simulator training

    NARCIS (Netherlands)

    Luursema, J.M.

    2010-01-01

    Medical learning and training are fields in transition. Catalyst in this change is the introduction of digital technology, for example in the form of simulator technology in surgical training, and virtual learning environments in anatomical learning. The primary aim of this thesis is to help

  8. Use of Simulation in Canadian Neonatal-Perinatal Medicine Training Programs.

    Science.gov (United States)

    Wong, Jonathan; Finan, Emer; Campbell, Douglas

    2017-07-08

    Introduction Simulation is used for the delivery of education and on occasion assessment. Before such a tool is used routinely in neonatal training programs across Canada, a need assessment is required to determine its current usage by accredited training programs. Our aim was to characterize the type of simulation modalities used and the perceived simulation-based training needs in Canadian neonatal-perinatal medicine (NPM) training programs. Methods A 22-item and 13-item online descriptive survey was sent to all NPM program directors and fellows in Canada, respectively. The survey was modeled on a previously validated tool by Johnston, et al. and responses were collected over 30 days. Results In total, eight (63%) program directors and 24 (28%) fellows completed the survey, with all respondents indicating that simulation is being used. Both lab-based and in situ simulations are occurring, with a range of simulation modalities employed to primarily teach resuscitation, procedural and communication skills. Fellows indicated that simulation should also be used to also teach other important topics, including disease-specific management, crisis resource management, and prevention of medical error. Five (63%) programs have faculty with formal simulation training and four (50%) programs have at least one faculty involved in simulation research. Conclusion Simulation is widely used in Canadian NPM training programs, with program directors and fellows identifying this as an important tool. Simulation can be used to teach a range of skills, but programs need to align their curriculum with both training objectives and learner needs. There is an opportunity for faculty development and increased simulation research.

  9. 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

  10. Ethical Issues in Parent Training Programs.

    Science.gov (United States)

    Sapon-Shevin, Mara

    1982-01-01

    Four areas of ethical concern are voiced in the training of parents of handicapped children: (1) selection of program goals, (2) problems involved with both positive reinforcement and punishment, (3) conflicts between experimentation and therapeutic intervention, and (4) level of parent training. Consideration of ethical issues at each step of…

  11. Export Management Specialist. A Training Program. Instructor's Edition.

    Science.gov (United States)

    Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

    This publication provides instructors with materials for an export management specialist (EMS) training program. The objective of the training program is to assist companies in reaching their export goals by educating current and potential managers about the basics of exporting. It provides a foundation for considering international trade and for…

  12. 32 CFR 634.10 - Remedial driver training programs.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Remedial driver training programs. 634.10 Section 634.10 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION Driving Privileges § 634.10 Remedial driver training programs. (a) Navy...

  13. E-Basics: Online Basic Training in Program Evaluation

    Science.gov (United States)

    Silliman, Ben

    2016-01-01

    E-Basics is an online training in program evaluation concepts and skills designed for youth development professionals, especially those working in nonformal science education. Ten hours of online training in seven modules is designed to prepare participants for mentoring and applied practice, mastery, and/or team leadership in program evaluation.…

  14. 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.

  15. [Modern didactics in surgical education--between demand and reality].

    Science.gov (United States)

    Pape-Köhler, C; Chmelik, C; Rose, M; Heiss, M M

    2010-12-01

    Surgical residency contains an inadequate amount of hands-on training in the operating room and time constraints further make this type of education on the floor unlikely. Due to these deficits in residency training, private surgical courses outside of the established residency programmes are in high demand. Therefore, surgical residents must spend their own resources and time in addition to their residency training in order to receive adequate clinical exposure. Didactic approaches like problem-based learning have begun to influence our modern education. These novel education approaches along with visualisation training, video-based presentations, and multimedia-based training can be useful adjuncts to traditional surgical training. © Georg Thieme Verlag Stuttgart ˙ New York.

  16. Do volunteers reduce the costs of parent training programs?

    DEFF Research Database (Denmark)

    Scavenius Sonne-Schmidt, Christoffer; Amilon, Anna; Schultz, Esben Anton

    ADHD in children has considerable negative consequences for both affected individuals and their families. One way to milden these negative consequences is by offering parents training in how to handle the child’s difficulties. However, running parent training programs is associated with substanti...... programs. Although direct comparison is difficult due to different outcome measures being used in comparable studies, our findings suggest that Caring in Chaos constitutes a commendable alternative to validated parent training programs such as Triple P and The Incredible Years...

  17. Hanford general employee training - A million dollar cost beneficial program

    International Nuclear Information System (INIS)

    Gardner, P.R.

    1991-02-01

    In January 1990, Westinghouse Hanford Company implemented an interactive videodisc training program entitled Hanford General Employee Training. Covering all Institute of Nuclear Power Operations general employee training objectives, training mandated by US Department of Energy orders, and training prescribed by internal Westinghouse Hanford Company policies, Hanford General Employee Training presents and manages engaging training programs individually tailored to each of the 9,000 employees. Development costs for a sophisticated program such as Hanford General Employee Training were high compared to similar costs for developing ''equivalent'' traditional training. Hardware ($500,000) and labor costs ($400,000) totaled $900,000. Annual maintenance costs, equipment plus labor, are totalling about $200,000. On the benefit side, by consolidating some 17 previous Westinghouse Hanford Company courses and more effectively managing the instructional process, Hanford General Employee Training reduced the average student training time from over 11 hours to just under 4 hours. For 9,000 employees, the computed net annual savings exceeds $1.3 million. 2 refs

  18. The Design of Model-Based Training Programs

    Science.gov (United States)

    Polson, Peter; Sherry, Lance; Feary, Michael; Palmer, Everett; Alkin, Marty; McCrobie, Dan; Kelley, Jerry; Rosekind, Mark (Technical Monitor)

    1997-01-01

    This paper proposes a model-based training program for the skills necessary to operate advance avionics systems that incorporate advanced autopilots and fight management systems. The training model is based on a formalism, the operational procedure model, that represents the mission model, the rules, and the functions of a modem avionics system. This formalism has been defined such that it can be understood and shared by pilots, the avionics software, and design engineers. Each element of the software is defined in terms of its intent (What?), the rationale (Why?), and the resulting behavior (How?). The Advanced Computer Tutoring project at Carnegie Mellon University has developed a type of model-based, computer aided instructional technology called cognitive tutors. They summarize numerous studies showing that training times to a specified level of competence can be achieved in one third the time of conventional class room instruction. We are developing a similar model-based training program for the skills necessary to operation the avionics. The model underlying the instructional program and that simulates the effects of pilots entries and the behavior of the avionics is based on the operational procedure model. Pilots are given a series of vertical flightpath management problems. Entries that result in violations, such as failure to make a crossing restriction or violating the speed limits, result in error messages with instruction. At any time, the flightcrew can request suggestions on the appropriate set of actions. A similar and successful training program for basic skills for the FMS on the Boeing 737-300 was developed and evaluated. The results strongly support the claim that the training methodology can be adapted to the cockpit.

  19. Evaluating the effectiveness of operator education/training program of Fugen

    International Nuclear Information System (INIS)

    Maeda, Kouichi; Sakruai, Naoto; Nakamura, Shinji

    2003-01-01

    The ATR Fugen determines 'the Operator Education/Training Program' for plant operators to acquire knowledge, technique and skill from the reactor facility, operation and the other nuclear plant technology. This program consists of the On-the-Job Training (OJT), desk education, ETC training, compact simulator FATRAS training, and lectures in external organization. So it provides education/training according to operators' technical level, knowledge, and experience. Fugen is investigating the most suitable training/education based on past training/education experience. (author)

  20. 25 CFR 26.32 - What constitutes a complete Job Training Program application?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What constitutes a complete Job Training Program... JOB PLACEMENT AND TRAINING PROGRAM Training Services § 26.32 What constitutes a complete Job Training Program application? A request for training includes: (a) Intake and application data; (b) Feasible...

  1. Implementation of surgical debriefing programs in large health systems: an exploratory qualitative analysis.

    Science.gov (United States)

    Brindle, Mary E; Henrich, Natalie; Foster, Andrew; Marks, Stanley; Rose, Michael; Welsh, Robert; Berry, William

    2018-03-27

    The role of the "debrief" to address issues related to patient safety and systematic flaws in care is frequently overlooked. In our study, we interview surgical leaders who have developed successful strategies of debriefing within a comprehensive program of quality improvement. Semi-structured interviews of four implementation leaders were performed. The observations, beliefs and strategies of surgical leaders are compared and contrasted. Common themes are identified related to program success and failure. Quality and safety researchers performed, coded and categorized the interviews and coordinated the analysis and interpretation of the results. The authors from the four institutions aided in interpretation and framing of the results. The debriefing programs evaluated were part of comprehensive quality improvement projects. Seven high-level themes and 24 subthemes were identified from the interviews. Themes related to leadership included early engagement, visible ongoing commitment and enforcement. Success appeared to depend upon meaningful and early debriefing feedback. The culture of safety that promoted success included a commitment to open and fair communication and continuous improvement. There were many challenges to the success of debriefing programs. The loss of institutional commitment of resources and personnel was the instigating factor behind the collapse of the program at Michigan. Other areas of potential failure included communication issues and loss of early and meaningful feedback. Leaders of four surgical systems with strong debriefing programs report success using debriefing to improve system performance. These findings are consistent with previously published studies. Success requires commitment of resources, and leadership engagement. The greatest gains may be best achieved by programs that provide meaningful debriefing feedback in an atmosphere dedicated to open communication.

  2. 25 CFR 26.4 - Who administers the Job Placement and Training Program?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Who administers the Job Placement and Training Program... PLACEMENT AND TRAINING PROGRAM General Applicability § 26.4 Who administers the Job Placement and Training Program? The Job Placement and Training Program is administered by the Bureau of Indian Affairs or a...

  3. Building capacity for water, sanitation, and hygiene programming: Training evaluation theory applied to CLTS management training in Kenya.

    Science.gov (United States)

    Crocker, Jonny; Shields, Katherine F; Venkataramanan, Vidya; Saywell, Darren; Bartram, Jamie

    2016-10-01

    Training and capacity building are long established critical components of global water, sanitation, and hygiene (WaSH) policies, strategies, and programs. Expanding capacity building support for WaSH in developing countries is one of the targets of the Sustainable Development Goals. There are many training evaluation methods and tools available. However, training evaluations in WaSH have been infrequent, have often not utilized these methods and tools, and have lacked rigor. We developed a conceptual framework for evaluating training in WaSH by reviewing and adapting concepts from literature. Our framework includes three target outcomes: learning, individual performance, and improved programming; and two sets of influences: trainee and context factors. We applied the framework to evaluate a seven-month community-led total sanitation (CLTS) management training program delivered to 42 government officials in Kenya from September 2013 to May 2014. Trainees were given a pre-training questionnaire and were interviewed at two weeks and seven months after initial training. We qualitatively analyzed the data using our conceptual framework. The training program resulted in trainees learning the CLTS process and new skills, and improving their individual performance through application of advocacy, partnership, and supervision soft skills. The link from trainees' performance to improved programming was constrained by resource limitations and pre-existing rigidity of trainees' organizations. Training-over-time enhanced outcomes and enabled trainees to overcome constraints in their work. Training in soft skills is relevant to managing public health programs beyond WaSH. We make recommendations on how training programs can be targeted and adapted to improve outcomes. Our conceptual framework can be used as a tool both for planning and evaluating training programs in WaSH. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. A survey to determine the potential impact of foundation year career aims on surgical specialty training.

    Science.gov (United States)

    Patel, Rikesh Kumar; Sayers, Adele Elizabeth; Akbar, Muhammad Jawaid; Hunter, Iain Andrew

    2014-03-01

    The competition for Core Surgical Training (CST) positions and subsequent Surgical Specialty Training (ST3) posts throughout the UK is fierce. Our aim was to conduct a pilot study to assess whether current foundation year doctors were considering pursuing a career in surgery and the reasons guiding their decisions. A ten-item questionnaire was voluntarily completed by foundation doctors at a large acute teaching trust. Factors evaluated included: experience working within a surgical rotation; previous consideration of a career in surgery; whether they found a career in surgery appealing; reasons guiding their decision and would they be applying to CST. All 67 foundation doctors approached agreed to participate: of which 56 (83.6%) had experience working within a surgical rotation. Males were significantly more likely to find a career in surgery appealing (p career, only 11 (16.4%) would be applying to CST. Reasons for finding a career in surgery appealing included: job satisfaction (84.2%), diversity of work (79.0%) and working environment/colleagues (47.4%). Of those that did not consider a career in surgery to be appealing, reasons included: working hours (75.0%), work/life balance (62.5%), working environment/colleagues (50%). Although only a small proportion of current foundation doctors were surveyed in our study, only 16.4% were considering applying for CST. These figures are lower than previously suggested and would indicate that there will be fewer applicants for CST in future years, which may potentially reduce the current bottleneck of applicants at ST3.

  5. Mapping training needs for dissemination and implementation research: lessons from a synthesis of existing D&I research training programs.

    Science.gov (United States)

    Chambers, David A; Proctor, Enola K; Brownson, Ross C; Straus, Sharon E

    2017-09-01

    With recent growth in the field of dissemination and implementation (D&I) research, multiple training programs have been developed to build capacity, including summer training institutes, graduate courses, degree programs, workshops, and conferences. While opportunities for D&I research training have expanded, course organizers acknowledge that available slots are insufficient to meet demand within the scientific and practitioner community. In addition, individual programs have struggled to best fit various needs of trainees, sometimes splitting coursework between specific D&I content and more introductory grant writing material. This article, stemming from a 2013 NIH workshop, reviews experiences across multiple training programs to align training needs, career stage and role, and availability of programs. We briefly review D&I needs and opportunities by career stage and role, discuss variations among existing training programs in format, mentoring relationships, and other characteristics, identify challenges of mapping needs of trainees to programs, and present recommendations for future D&I research training.

  6. Providing surgical care in Somalia: A model of task shifting.

    Science.gov (United States)

    Chu, Kathryn M; Ford, Nathan P; Trelles, Miguel

    2011-07-15

    Somalia is one of the most political unstable countries in the world. Ongoing insecurity has forced an inconsistent medical response by the international community, with little data collection. This paper describes the "remote" model of surgical care by Medecins Sans Frontieres, in Guri-El, Somalia. The challenges of providing the necessary prerequisites for safe surgery are discussed as well as the successes and limitations of task shifting in this resource-limited context. In January 2006, MSF opened a project in Guri-El located between Mogadishu and Galcayo. The objectives were to reduce mortality due to complications of pregnancy and childbirth and from violent and non-violent trauma. At the start of the program, expatriate surgeons and anesthesiologists established safe surgical practices and performed surgical procedures. After January 2008, expatriates were evacuated due to insecurity and surgical care has been provided by local Somalian doctors and nurses with periodic supervisory visits from expatriate staff. Between October 2006 and December 2009, 2086 operations were performed on 1602 patients. The majority (1049, 65%) were male and the median age was 22 (interquartile range, 17-30). 1460 (70%) of interventions were emergent. Trauma accounted for 76% (1585) of all surgical pathology; gunshot wounds accounted for 89% (584) of violent injuries. Operative mortality (0.5% of all surgical interventions) was not higher when Somalian staff provided care compared to when expatriate surgeons and anesthesiologists. The delivery of surgical care in any conflict-settings is difficult, but in situations where international support is limited, the challenges are more extreme. In this model, task shifting, or the provision of services by less trained cadres, was utilized and peri-operative mortality remained low demonstrating that safe surgical practices can be accomplished even without the presence of fully trained surgeon and anesthesiologists. If security improves

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

    International Nuclear Information System (INIS)

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

    1999-01-01

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

  8. Attrition from surgical residency training: perspectives from those who left.

    Science.gov (United States)

    Bongiovanni, Tasce; Yeo, Heather; Sosa, Julie A; Yoo, Peter S; Long, Theodore; Rosenthal, Marjorie; Berg, David; Curry, Leslie; Nunez-Smith, Marcella

    2015-10-01

    High rates of attrition from general surgery residency may threaten the surgical workforce. We sought to gain further insight regarding resident motivations for leaving general surgery residency. We conducted in-depth interviews to generate rich narrative data that explored individual experiences. An interdisciplinary team used the constant comparative method to analyze the data. Four themes characterized experiences of our 19 interviewees who left their residency program. Participants (1) felt an informal contract was breached when clinical duties were prioritized over education, (2) characterized a culture in which there was no safe space to share personal and programmatic concerns, (3) expressed a scarcity of role models who demonstrated better work-life balance, and (4) reported negative interactions with authority resulting in a profound loss of commitment. As general surgery graduate education continues to evolve, our findings may inform interventions and policies regarding programmatic changes to boost retention in surgical residency. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. 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.

  10. Training in breast surgery in Spain.

    Science.gov (United States)

    Miguelena, José M; Domínguez Cunchillos, Fernando

    2016-01-01

    Breast surgery is a key part of training and competency in general surgery in Spain and is a "frontier area" that can be efficiently managed by general surgeons and gynecologists. The main objective of the training process consists of the surgical treatment of breast cancer, including conservative surgery, oncoplastic and reconstructive techniques. This article analyses the current status of breast surgery training in Spain and schematically proposes potential targets of the different training programs, to improve access and training for surgeons and residents in this area, taking into account the RD 639/2014 and European regulation. The priority is to specify the level of training that should be achieved, in relation to the group of professionals involved, considering their area of competency: surgery resident, educational programs, and surgeons with special dedication to this area. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Development of Capacity Building Training Programs for Nuclear R and D Personnel

    International Nuclear Information System (INIS)

    Lee, Eui Jin; Nam, Youngmi; Hwang, Hyeseon; Jang, Eunsook; Song, Eun Ju

    2016-01-01

    The Nuclear Training and Education Center of the Korea Atomic Energy Research Institute has been operating technical training courses on nuclear engineering, engineering mathematics, management leadership training, out sourced practical training, legal education, etc. Strengthening nuclear R and D capacity is essential for the long-term mission and goals of the institute. Therefore, it requires a comprehensive training program to strengthen the unique capability of the institute that reflects diversity and differentiation. In this regard, the capacity building training program has developed on a modular basis, and the developed training program should be tailored to operate according to the institute needs. The capacity building training program for nuclear R and D personnel was developed to reflect the technology strengths of the institute. The developed training program will be developed into a leading branded education of the institute in the future

  12. Development of Capacity Building Training Programs for Nuclear R and D Personnel

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eui Jin; Nam, Youngmi; Hwang, Hyeseon; Jang, Eunsook; Song, Eun Ju [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2016-10-15

    The Nuclear Training and Education Center of the Korea Atomic Energy Research Institute has been operating technical training courses on nuclear engineering, engineering mathematics, management leadership training, out sourced practical training, legal education, etc. Strengthening nuclear R and D capacity is essential for the long-term mission and goals of the institute. Therefore, it requires a comprehensive training program to strengthen the unique capability of the institute that reflects diversity and differentiation. In this regard, the capacity building training program has developed on a modular basis, and the developed training program should be tailored to operate according to the institute needs. The capacity building training program for nuclear R and D personnel was developed to reflect the technology strengths of the institute. The developed training program will be developed into a leading branded education of the institute in the future.

  13. The development of a TED-Ed online resident research training program.

    Science.gov (United States)

    Moreau, Katherine A; Pound, Catherine M; Peddle, Beth; Tokarewicz, Jaclyn; Eady, Kaylee

    2014-01-01

    Pediatric health research is important for improving the health and well-being of children and their families. To foster the development of physicians' research competencies, it is vital to integrate practical and context-specific research training into residency programs. To describe the development of a resident research training program at one tertiary care pediatric academic health sciences center in Ontario, Canada. We surveyed residents and pediatricians/research staff to establish the need and content for a resident research training program. Residents and resident research supervisors agreed or strongly agreed that research training is important for residents. However, few residents and supervisors believed that their academic health sciences center provided adequate training and resources to support resident research. As such, an online resident research training program was established. Residents and supervisors agreed that the program should focus on the following topics: 1) critically evaluating research literature, 2) writing a research proposal, 3) submitting an application for research funding, and 4) writing a manuscript. This highly accessible, context-specific, and inexpensive online program model may be of interest and benefit to other residency programs as a means to enhance residents' scholarly roles. A formal evaluation of the research training program is now underway.

  14. The development of a TED-Ed online resident research training program

    Directory of Open Access Journals (Sweden)

    Katherine A. Moreau

    2014-12-01

    Full Text Available Background: Pediatric health research is important for improving the health and well-being of children and their families. To foster the development of physicians’ research competencies, it is vital to integrate practical and context-specific research training into residency programs. Purpose: To describe the development of a resident research training program at one tertiary care pediatric academic health sciences center in Ontario, Canada. Methods: We surveyed residents and pediatricians/research staff to establish the need and content for a resident research training program. Results: Residents and resident research supervisors agreed or strongly agreed that research training is important for residents. However, few residents and supervisors believed that their academic health sciences center provided adequate training and resources to support resident research. As such, an online resident research training program was established. Residents and supervisors agreed that the program should focus on the following topics: 1 critically evaluating research literature, 2 writing a research proposal, 3 submitting an application for research funding, and 4 writing a manuscript. Discussion: This highly accessible, context-specific, and inexpensive online program model may be of interest and benefit to other residency programs as a means to enhance residents’ scholarly roles. A formal evaluation of the research training program is now underway.

  15. INPO JTA application: developing a competency-based training program

    International Nuclear Information System (INIS)

    Patrick, P.W.

    1985-01-01

    Developing a competency-based training program requires the support of a strong curriculum development program. The major thrust of Arkansas Power and Light Company's competency-based curriculum development program is the identification of competencies using position task analysis data, panels, and INPO JTA data. Eight steps in the curriculum development approach provide the logic and rationale of the process: (1) establish competencies, (2) conduct competency verification, (3) develop competency tests, (4) develop curriculum, (5) develop instructional media, (6) validate curriculum and conduct field testing, (7) perform training effectiveness evaluation, and (8) revise the curriculum as needed. The processes describe how INPO JTA's and NRC procedures are cross-referenced to show that standards and requirements imposed or sanctioned by NRC and INPO are met. The competency-based approach to curriculum and training development eliminates the traditional scatterload approach to training and focuses on training to the competency. The primary benefits of competency-based training include accountability, minimal job training to meet job or position requirements, and a process to document an individual's job proficiency

  16. 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.

  17. Simulation-based surgical education.

    Science.gov (United States)

    Evgeniou, Evgenios; Loizou, Peter

    2013-09-01

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

  18. 75 FR 13521 - Centers for Independent Living Program-Training and Technical Assistance

    Science.gov (United States)

    2010-03-22

    ... DEPARTMENT OF EDUCATION Centers for Independent Living Program--Training and Technical Assistance... for Independent Living Program--Training and Technical Assistance (CIL-TA program). The Assistant... appropriated for the CIL program to provide training and technical assistance to CILs, agencies eligible to...

  19. A low-cost bioprosthetic semilunar valve for research, disease modelling and surgical training applications.

    Science.gov (United States)

    Rosa, Benoit; Machaidze, Zurab; Shin, Borami; Manjila, Sunil; Brown, David W; Baird, Christopher W; Mayer, John E; Dupont, Pierre E

    2017-11-01

    This paper provides detailed instructions for constructing low-cost bioprosthetic semilunar valves for animal research and clinical training. This work fills an important gap between existing simulator training valves and clinical valves by providing fully functioning designs that can be employed in ex vivo and in vivo experiments and can also be modified to model valvular disease. Valves are constructed in 4 steps consisting of creating a metal frame, covering it with fabric and attaching a suture ring and leaflets. Computer-aided design files are provided for making the frame from wire or by metal 3D printing. The covering fabric and suturing ring are made from materials readily available in a surgical lab, while the leaflets are made from pericardium. The entire fabrication process is described in figures and in a video. To demonstrate disease modelling, design modifications are described for producing paravalvular leaks, and these valves were evaluated in porcine ex vivo (n = 3) and in vivo (n = 6) experiments. Porcine ex vivo and acute in vivo experiments demonstrate that the valves can replicate the performance of clinical valves for research and training purposes. Surgical implantation is similar, and echocardiograms are comparable to clinical valves. Furthermore, valve leaflet function was satisfactory during acute in vivo tests with little central regurgitation, while the paravalvular leak modifications consistently produced leaks in the desired locations. The detailed design procedure presented here, which includes a tutorial video and computer-aided design files, should be of substantial benefit to researchers developing valve disease models and to clinicians developing realistic valve training systems. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  20. Initiatives in training program evaluation outside the nuclear utility industry

    International Nuclear Information System (INIS)

    Allen, C.J.

    1987-01-01

    Training literature is reviewed, and program evaluative practices outside the nuclear utility industry are reported. The findings indicate some innovations in philosophy and practice and program evaluation, although not necessarily in the context of evaluation as a route to assessing the impact of training. Program evaluation is described in the context of the impact of training, suggesting continued efforts to accept a multivariate concept of individual and organizational performance

  1. Family Therapy Training in Child and Adolescent Psychiatry Fellowship Programs

    Science.gov (United States)

    Rait, Douglas Samuel

    2012-01-01

    Objective: This study describes the current state of family therapy training in a sample of child and adolescent psychiatry fellowship programs. Method: Child and adolescent psychiatry fellows (N = 66) from seven training programs completed a questionnaire assessing demographics, family therapy training experiences, common models of treatment and…

  2. Determining personal talents and behavioral styles of applicants to surgical training: a new look at an old problem, part II.

    Science.gov (United States)

    Bell, Richard M; Fann, Stephen A; Morrison, James E; Lisk, J Ryan

    2012-01-01

    The selection of applicants for training in any particular surgical program is an imprecise exercise. Despite the abundance of information on particular candidates, many of the fundamental qualities that are associated with success for the surgical trainee cannot be identified by review of the applicants' grades, scores, letters of recommendation, personal statement, or even from the interview process. We sought a method to determine behavior, motivation, and values possessed by applicants that coincided with traits by our current residents who had demonstrated success in our program. The methods have been described in detail in Part I.(1) Briefly, the individual applicants' personal talent report was used to develop a rank-ordered list by the outside consultant and was compared to the traditionally developed rank list developed by the Department in the traditional fashion and the newly developed job benchmark. Five hundred thirty-five applications were received and interviews were offered to 112 (21%) applicants. Seventy-five on-line surveys were completed by the 77 applicants who were interviewed. The consultant was able to identify important personal talents, elements of motivation, and behavioral style that were not gleaned from the application or the interview process, some of which prompted a revision of our final ranking order.(1) This report discusses the results of the motivational analysis and of the Personal Talents Skills Inventory. Applicants with a strong motivation for the theoretical (knowledge) and social commitment (desire to help others) are important characteristics. Clear views of the external world and of self, as well as a sense of satisfaction with the applicants' vision of their future are positively associated with success in our program. The ability to identify unique behavioral, motivational and personal talents that applicants bring to the program that were not identifiable from the traditional application and interview process has

  3. Designing a leadership development program for surgeons.

    Science.gov (United States)

    Jaffe, Gregory A; Pradarelli, Jason C; Lemak, Christy Harris; Mulholland, Michael W; Dimick, Justin B

    2016-01-01

    Although numerous leadership development programs (LDPs) exist in health care, no programs have been specifically designed to meet the needs of surgeons. This study aimed to elicit practicing surgeons' motivations and desired goals for leadership training to design an evidence-based LDP in surgery. At a large academic health center, we conducted semistructured interviews with 24 surgical faculty members who voluntarily applied and were selected for participation in a newly created LDP. Transcriptions of the interviews were analyzed using analyst triangulation and thematic coding to extract major themes regarding surgeons' motivations and perceived needs for leadership knowledge and skills. Themes from interview responses were then used to design the program curriculum specifically to meet the leadership needs of surgical faculty. Three major themes emerged regarding surgeons' motivations for seeking leadership training: (1) Recognizing key gaps in their formal preparation for leadership roles; (2) Exhibiting an appetite for personal self-improvement; and (3) Seeking leadership guidance for career advancement. Participants' interviews revealed four specific domains of knowledge and skills that they indicated as desired takeaways from a LDP: (1) leadership and communication; (2) team building; (3) business acumen/finance; and (4) greater understanding of the health care context. Interviews with surgical faculty members identified gaps in prior leadership training and demonstrated concrete motivations and specific goals for participating in a formal leadership program. A LDP that is specifically tailored to address the needs of surgical faculty may benefit surgeons at a personal and institutional level. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. International Training Program on Nuclear Engineering at Kinki University

    International Nuclear Information System (INIS)

    Hohara, Sin-ya; Wakabayashi, Genichiro; Yamanishi, Hirokuni; Itoh, Tetsuo

    2014-01-01

    Outline of the Training Program: • This training program is a 3-years program since 2013. • This program is conducted with 5 universities’ cooperation: Kyushu Univ., Nagoya Univ., Kyung Hee Univ., Kyoto Univ. and Kinki Univ.; • Education is provided in 3 experimental fields: Kinki Univ. Reactor: UTR-KINKI, Kyung Hee Univ. Reactor: AGN-201K, Reconstruction Support Test Field in Fukushima: RSTF; • The language used in the program is English which is not mother tongue for neither Japanese nor Korean students

  5. Demographic Changes in School Psychology Training Programs between 1997 and 2005

    Science.gov (United States)

    Cannon, Sharon

    2009-01-01

    The purpose of this study seeks to add to the body of knowledge regarding school psychology training programs by analyzing the data of the 2005 National Association of School Psychologists (NASP) Graduate Training in School Psychology Database, a national survey of psychology training programs. Program directors of all known existing school…

  6. 30 CFR 75.1713-6 - First-aid training program; minimum requirements.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false First-aid training program; minimum... § 75.1713-6 First-aid training program; minimum requirements. (a) All first-aid training programs... course of instruction similar to that outlined in “First Aid, A Bureau of Mines Instruction Manual.” (b...

  7. Implementation of a Novel Structured Social and Wellness Committee in a Surgical Residency Program: A Case Study.

    Science.gov (United States)

    Van Orden, Kathryn E; Talutis, Stephanie D; Ng-Glazier, Joanna H; Richman, Aaron P; Pennington, Elliot C; Janeway, Megan G; Kauffman, Douglas F; Dechert, Tracey A

    2017-01-01

    This article provides a theoretical and practical rational for the implementation of an innovative and comprehensive social wellness program in a surgical residency program at a large safety net hospital on the East Coast of the United States. Using basic needs theory, we describe why it is particularly important for surgical residency programs to consider the residents sense of competence, autonomy, and belonging during residence. We describe how we have developed a comprehensive program to address our residents' (and residents' families) psychological needs for competence, autonomy, and belongingness.

  8. 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.

  9. European advanced driver training programs: Reasons for optimism

    Directory of Open Access Journals (Sweden)

    Simon Washington

    2011-03-01

    This paper reviews the predominant features and empirical evidence surrounding post licensing advanced driver training programs focused on novice drivers. A clear articulation of differences between the renewed and current US advanced driver training programs is provided. While the individual quantitative evaluations range from marginally to significantly effective in reducing novice driver crash risk, they have been criticized for evaluation deficiencies ranging from small sample sizes to confounding variables to lack of exposure metrics. Collectively, however, the programs sited in the paper suggest at least a marginally positive effect that needs to be validated with further studies. If additional well controlled studies can validate these programs, a pilot program in the US should be considered.

  10. ISO training program mixes lectures, hands-on exercises

    International Nuclear Information System (INIS)

    Sakofsky, S.; Vitale, D.

    1994-01-01

    Early in 1990, the Dresser-Rand Co., made the decision to upgrade its purchased material quality program and pursue ISO 9000 registration for all product divisions. A joint quality-purchasing council from all US based divisions met and developed a new strategy that included: developing and maintaining a common external audit schedule eliminating duplicate audits; development of a formal training program for auditors; implementing a rule for all divisions that called for internal and external audits to be conducted by certified auditors; implementing an aggressive internal audit program for each division preparing for ISO 9001 or 9002 registration. Development of a formal training program began with educating and training future instructors. Two people were selected who had previous audit and quality system experience. Both were sent to various seminars on ISO 9000, attended a lead assessor course, passed the examination, and became registered with the Institute of Quality Assurance (IQA) in the United Kingdom. The original course was developed by a consultant along with one future instructor. Course content used traditional auditing methodology, but included many team exercises including an actual factory audit. The paper describes the methods and contents of this training course

  11. Addressing Professionalism, Social, and Communication Competencies in Surgical Residency Via Integrated Humanities Workshops: A Pilot Curriculum.

    Science.gov (United States)

    Colvin, Jennifer; French, Judith; Siperstein, Allan; Capizzani, Tony R; Krishnamurthy, Vikram D

    We aimed to conduct professionalism and social competencies (PSC) training by integrating humanities into structured workshops, and to assess reception of this curriculum by first-year surgical residents. An IRB-approved, pilot curriculum consisting of 4 interactive workshops for surgical interns was developed. The workshops were scheduled quarterly, often in small group format, and supplemental readings were assigned. Humanities media utilized to illustrate PSC included survival scenarios, reflective writing, television portrayals, and social media. Emphasis was placed on recognizing personal values and experiences that influence judgment and decision-making, using social media responsibly, identifying and overcoming communication barriers related to generational changes in training (especially technology and work-life balance), and tackling stereotypes of surgeons. Anonymous and voluntary pre- and postcurriculum surveys were administered. Univariate analysis of responses was performed with JMP Pro v12 using Fisher's exact, χ 2 , and Students' t-tests for categorical and continuous variables. The study took place at the Cleveland Clinic in Cleveland, OH, within the general surgery program. Surgical interns at the Cleveland Clinic were included in the study. A total of 16 surgical interns completed the curriculum. Sixteen surgical interns participated in the curriculum: 69% were domestic medical school graduates (DG) and 31% were international medical school graduates (IMG). Overall, the majority (81%) of residents had received PSC courses during medical school: 100% of DG compared to 40% of IMG (p = 0.02). Before beginning the curriculum, 86% responded that additional PSC training would be useful during residency, which increased to 94% upon completion (p = 0.58). Mean number of responses supporting the usefulness of PSC training increased from 1.5 ± 0.2 before the curriculum to 1.75 ± 0.2 upon completion (p = 0.4). When describing public and medical student

  12. 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.

  13. Regulatory activities in gaining assurance of training program effectiveness in Canada

    International Nuclear Information System (INIS)

    Legare, Michele

    2003-01-01

    This presentation shows the regulator's point of view on evaluating a training program effectiveness. The mission of the Training Program Evaluation Section of the Canadian Atomic Energy Control Board is to obtain and document assurance that the training of NPP operators is effective in providing them with the knowledge and skills needed to become and remain competent. Proposals are made to be considered when drafting the IAEA guideline on evaluation of training program effectiveness

  14. Needs assessment for simulation training in neuroendoscopy: a Canadian national survey.

    Science.gov (United States)

    Haji, Faizal A; Dubrowski, Adam; Drake, James; de Ribaupierre, Sandrine

    2013-02-01

    In recent years, dramatic changes in surgical education have increased interest in simulation-based training for complex surgical skills. This is particularly true for endoscopic third ventriculostomy (ETV), given the potential for serious intraoperative errors arising from surgical inexperience. However, prior to simulator development, a thorough assessment of training needs is essential to ensure development of educationally relevant platforms. The purpose of this study was to conduct a national needs assessment addressing specific goals of instruction, to guide development of simulation platforms, training curricula, and assessment metrics for ETV. Canadian neurosurgeons performing ETV were invited to participate in a structured online questionnaire regarding the procedural steps for ETV, the frequency and significance of intraoperative errors committed while learning the technique, and simulation training modules of greatest potential educational benefit. Descriptive data analysis was completed for both quantitative and qualitative responses. Thirty-two (55.2%) of 58 surgeons completed the survey. All believed that virtual reality simulation training for ETV would be a valuable addition to clinical training. Selection of ventriculostomy site, navigation within the ventricles, and performance of the ventriculostomy ranked as the most important steps to simulate. Technically inadequate ventriculostomy and inappropriate fenestration site selection were ranked as the most frequent/significant errors. A standard ETV module was thought to be most beneficial for resident training. To inform the development of a simulation-based training program for ETV, the authors have conducted a national needs assessment. The results provide valuable insight to inform key design elements necessary to construct an educationally relevant device and educational program.

  15. A Rural Special Education Teacher Training Program: Successful Adaptations.

    Science.gov (United States)

    Prater, Greg; And Others

    The Rural Special Education Program (RSEP), a partnership between Northern Arizona University (NAU) and Kayenta Unified School District (KUSD), provides training for preservice special education teachers to work with Native American students and their families. To date, the program has provided training for 63 preservice special education…

  16. A Strength Training Program for Primary Care Patients, Central Pennsylvania, 2012

    Science.gov (United States)

    Patel, Vijay A.; Kraschnewski, Jennifer L.; Rovniak, Liza S.; Messina, Dino A.; Stuckey, Heather L.; Curry, William J.; Chuang, Cynthia H.; Sherwood, Lisa L.; Hess, Stacy L.

    2014-01-01

    Introduction Primary care providers can recommend strength training programs to use “Exercise as Medicine,” yet few studies have examined the interest of primary care patients in these programs. Methods We conducted a cross-sectional survey of primary care patients in central Pennsylvania. Interest in participating in free group-based strength training and weight control programs was assessed, in addition to patient demographics, medical history, and quality of life. Results Among 414 patients, most (61.0%) were aged 54 or older, and 64.0% were female. More patients were interested in a strength training program (55.3%) than in a weight control program (45.4%). Nearly three-quarters (72.8%) of those reporting 10 or more days of poor physical health were interested in a strength training program compared with 49.5% of those reporting no days of poor physical health. After adjusting for potential confounders, those reporting poorer physical health had 2.7 greater odds (95% confidence interval, 1.4–5.1) of being interested in a strength training program compared with those reporting better physical health. Patients with hypertension, diabetes, or high cholesterol were not more interested in a strength training program than those without these conditions. Conclusion Primary care practices may consider offering or referring patients to community-based strength training programs. This study observed high levels of interest in these widely available programs. Practices may also consider screening and referring those with poorer physical health, as they may be the most interested and have the most to gain from participating. PMID:24967829

  17. Train Repathing in Emergencies Based on Fuzzy Linear Programming

    Directory of Open Access Journals (Sweden)

    Xuelei Meng

    2014-01-01

    Full Text Available Train pathing is a typical problem which is to assign the train trips on the sets of rail segments, such as rail tracks and links. This paper focuses on the train pathing problem, determining the paths of the train trips in emergencies. We analyze the influencing factors of train pathing, such as transferring cost, running cost, and social adverse effect cost. With the overall consideration of the segment and station capability constraints, we build the fuzzy linear programming model to solve the train pathing problem. We design the fuzzy membership function to describe the fuzzy coefficients. Furthermore, the contraction-expansion factors are introduced to contract or expand the value ranges of the fuzzy coefficients, coping with the uncertainty of the value range of the fuzzy coefficients. We propose a method based on triangular fuzzy coefficient and transfer the train pathing (fuzzy linear programming model to a determinate linear model to solve the fuzzy linear programming problem. An emergency is supposed based on the real data of the Beijing-Shanghai Railway. The model in this paper was solved and the computation results prove the availability of the model and efficiency of the algorithm.

  18. Train repathing in emergencies based on fuzzy linear programming.

    Science.gov (United States)

    Meng, Xuelei; Cui, Bingmou

    2014-01-01

    Train pathing is a typical problem which is to assign the train trips on the sets of rail segments, such as rail tracks and links. This paper focuses on the train pathing problem, determining the paths of the train trips in emergencies. We analyze the influencing factors of train pathing, such as transferring cost, running cost, and social adverse effect cost. With the overall consideration of the segment and station capability constraints, we build the fuzzy linear programming model to solve the train pathing problem. We design the fuzzy membership function to describe the fuzzy coefficients. Furthermore, the contraction-expansion factors are introduced to contract or expand the value ranges of the fuzzy coefficients, coping with the uncertainty of the value range of the fuzzy coefficients. We propose a method based on triangular fuzzy coefficient and transfer the train pathing (fuzzy linear programming model) to a determinate linear model to solve the fuzzy linear programming problem. An emergency is supposed based on the real data of the Beijing-Shanghai Railway. The model in this paper was solved and the computation results prove the availability of the model and efficiency of the algorithm.

  19. Feasibility and Benefit of Incorporating a Multimedia Cadaver Laboratory Training Program into a Didactics Curriculum for Junior and Senior Surgical Residents.

    Science.gov (United States)

    Simmerman, Erika; Simmerman, Andrew; Lassiter, Randi; King, Ray; Ham, Ben; Adam, Bao-Ling; Ferdinand, Colville; Holsten, Steven

    2018-04-17

    As operative experience in general surgery decreases and work hour limitations increase there is less exposure of surgical residents to advanced vascular and trauma exposures. Many institutions have demonstrated benefits of cadaver laboratory courses. We have incorporated a multimedia cadaver laboratory course into our general surgery residency didactics curriculum with the objective to demonstrate a benefit of the program as well as the feasibility of incorporation. This is a prospective study at a tertiary care institution including general surgery residents within our residency program. A curriculum was designed, requiring residents to complete multimedia learning modules before both a trauma cadaver laboratory and vascular exposure cadaver laboratory. Outcome measures included self-efficacy/confidence (precourse and postcourse 5-point Likert surveys), knowledge (net performance on precourse and postcourse multiple choice examinations), and resident perception of the curriculum (postcourse 5-point Likert survey). Data were analyzed using ANOVA paired t-tests. For the vascular cadaver laboratory, resident knowledge improved overall from an average of 41.2% to 50.0% of questions correct (p = 0.032) and self-efficacy/confidence improved by 0.59 from 1.52 to 2.11 out of 5 (p = 0.009). Median confidence is 1.37 out of 5 and 2.32 out of 5, before and after course, respectively. Wilcoxon nonparametric test reveals a p = 0.011. Resident's perception of the usefulness of the laboratory evaluation was 3.85 out 5. There were 85.71% agreed that the laboratory is useful and 14.29% were disagree. The Z-score is -0.1579 (means 0.1579 standard deviations a score of 3.85 below the benchmark). The percentile rank is 56.27%. The coefficient of variation is 24.68%. For the trauma cadaver laboratory, resident knowledge improved overall from an average of 55.89% to 66.17% of questions correct (p = 0.001) and self-efficacy/confidence improved by 0.75 from 1.68 out of 5 to 2.43 out of

  20. Nuclear criticality safety specialist training and qualification programs

    International Nuclear Information System (INIS)

    Hopper, C.M.

    1993-01-01

    Since the beginning of the Nuclear Criticality Safety Division of the American Nuclear Society (ANS) in 1967, the nuclear criticality safety (NCS) community has sought to provide an exchange of information at a national level to facilitate the education and development of NCS specialists. In addition, individual criticality safety organizations within government contractor and licensed commercial nonreactor facilities have developed training and qualification programs for their NCS specialists. However, there has been substantial variability in the content and quality of these program requirements and personnel qualifications, at least as measured within the government contractor community. The purpose of this paper is to provide a brief, general history of staff training and to describe the current direction and focus of US DOE guidance for the content of training and qualification programs designed to develop NCS specialists

  1. Physician training protocol within the WEB Intrasaccular Therapy (WEB-IT) study.

    Science.gov (United States)

    Arthur, Adam; Hoit, Daniel; Coon, Alexander; Delgado Almandoz, Josser E; Elijovich, Lucas; Cekirge, Saruhan; Fiorella, David

    2018-05-01

    The WEB Intra-saccular Therapy (WEB-IT) trial is an investigational device exemption study to demonstrate the safety and effectiveness of the WEB device for the treatment of wide-neck bifurcation aneurysms. The neurovascular replicator (Vascular Simulations, Stony Brook, New York, USA) creates a physical environment that replicates patient-specific neurovascular anatomy and hemodynamic physiology, and allows devices to be implanted under fluoroscopic guidance. To report the results of a unique neurovascular replicator-based training program, which was incorporated into the WEB-IT study to optimize technical performance and patient safety. US investigators participated in a new training program that incorporated full surgical rehearsals on a neurovascular replicator. No roll-in cases were permitted within the trial. Custom replicas of patient-specific neurovascular anatomy were created for the initial cases treated at each center, as well as for cases expected to be challenging. On-site surgical rehearsals were performed before these procedures. A total of 48 participating investigators at 25 US centers trained using the replicator. Sessions included centralized introductory training, on-site training, and patient-specific full surgical rehearsal. Fluoroscopy and procedure times in the WEB-IT study were not significantly different from those seen in two European trials where participating physicians had significant WEB procedure experience before study initiation. A new program of neurovascular-replicator-based physician training was employed within the WEB-IT study. This represents a new methodology for education and training that may be an effective means to optimize technical success and patient safety during the introduction of a new technology. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Encuesta de opinión sobre la cirugía mayor ambulatoria en la formación del residente de especialidades quirúrgicas Opinion survey of the effect of major ambulatory surgery on the training of surgical residents

    Directory of Open Access Journals (Sweden)

    Carlos Martínez Ramos

    2004-12-01

    constitute to a large extent the basis of surgical training. The objectives of this study are to assess the opinions of the surgical residents of the likely effects of the advent of MAS on their surgical training, and to record any solutions that they may propose. Material and Methods: A survey of 17 questions (13 closed, 2 open and 1 mixed was administered to 72 residents training in seven of the surgical specialties that participate at the MAS Unit at the Hospital San Carlos, Madrid. Results: The survey was completed by 36.1% of residents. All those that responded considered that: 1 familiarity with, and training in, this type of surgery is important . 2 the surgical techniques performed at the Hospital’s MAS Unit are fundamental for the surgical training of the resident. 3 Major Ambulatory Surgery should be included in the training of surgical residents. 80.8% consider that receiving MAS training will improve their employment prospects on finishing their residence period. Conclusions: Residents consider that their participation in the activity of MAS Units is important and that well-structured, well-coordinated programs are required. All parties involved should participate in the preparation of the programs, which should be adapted to the characteristics of each specialty.

  3. 34 CFR 395.11 - Training program for blind individuals.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Training program for blind individuals. 395.11 Section... BLIND ON FEDERAL AND OTHER PROPERTY The State Licensing Agency § 395.11 Training program for blind... be provided to blind individuals as vocational rehabilitation services under the Rehabilitation Act...

  4. Model for behavior observation training programs

    International Nuclear Information System (INIS)

    Berghausen, P.E. Jr.

    1987-01-01

    Continued behavior observation is mandated by ANSI/ANS 3.3. This paper presents a model for behavior observation training that is in accordance with this standard and the recommendations contained in US NRC publications. The model includes seventeen major topics or activities. Ten of these are discussed: Pretesting of supervisor's knowledge of behavior observation requirements, explanation of the goals of behavior observation programs, why behavior observation training programs are needed (legal and psychological issues), early indicators of emotional instability, use of videotaped interviews to demonstrate significant psychopathology, practice recording behaviors, what to do when unusual behaviors are observed, supervisor rationalizations for noncompliance, when to be especially vigilant, and prevention of emotional instability

  5. Characteristics and Outcomes of an Innovative Train-in-Place Residency Program.

    Science.gov (United States)

    Green-McKenzie, Judith; Emmett, Edward A

    2017-10-01

    Physicians who make a midcareer specialty change may find their options for formal training are limited. Here, we describe a train-in-place program, with measureable outcomes, created to train midcareer physicians who desire formal training in occupational medicine. We evaluated educational outcomes from a novel residency program for midcareer physicians seeking formal training and board certification in occupational medicine. Physicians train in place at selected clinical training sites where they practice, and participate in 18 visits to the primary training site over a 2-year period. Program components include competency-based training structured around rotations, mentored projects, and periodic auditing visits to train-in-site locations by program faculty. Main outcome measures are achievement of Accreditation Council for Graduate Medical Education Occupational Medicine Milestones, American College of Occupational and Environmental Medicine competencies, performance on the American College of Preventive Medicine examinations, diversity in selection, placement of graduates, and the number of graduates who remain in the field. Since inception of this program in 1997, there have been 109 graduates who comprise 7.2% of new American Board of Preventive Medicine diplomates over the past decade. Graduates scored competitively on the certifying examination, achieved all milestones, expressed satisfaction with training, and are geographically dispersed, representing every US region. Most practice outside the 25 largest standard metropolitan statistical areas. More than 95% have remained in the field. Training in place is an effective approach to provide midcareer physicians seeking comprehensive skills and board certification in occupational medicine formal training, and may be adaptable to other specialties.

  6. Breaking bad news: A communication competency for ophthalmology training programs.

    Science.gov (United States)

    Hilkert, Sarah M; Cebulla, Colleen M; Jain, Shelly Gupta; Pfeil, Sheryl A; Benes, Susan C; Robbins, Shira L

    As the ophthalmology accreditation system undergoes major changes, training programs must evaluate residents in the 6 core competencies, including appropriately communicating bad news. Although the literature is replete with recommendations for breaking bad news across various non-ophthalmology specialties, no formal training programs exist for ophthalmology. There are many valuable lessons to be learned from our colleagues regarding this important skill. We examine the historic basis for breaking bad news, explore current recommendations among other specialties, and then evaluate a pilot study in breaking bad news for ophthalmology residents. The results of this study are limited by a small number of residents at a single academic center. Future studies from multiple training programs should be conducted to further evaluate the need and efficacy of formal communication skills training in this area, as well as the generalizability of our pilot training program. If validated, this work could serve as a template for future ophthalmology resident training and evaluation in this core competency. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Biosafety Education and Training Programs for Ukrainian Microbiologists

    International Nuclear Information System (INIS)

    Pushkina, V.; Volyansky, A.; Popova, N.

    2007-01-01

    In the period of the Soviet Union Ukrainian Mechnikov Anti-Plaque Research Institute was one of the main bases of centralized training for laboratory diagnosis of especially dangerous infections. Not only specialists, but medical technicians were obligatory trained. In training programs special attention was paid to the safety regime in accurate work out of practical manipulations in investigational classical methods (cultivating technique, pipeting, animals' infection and dissection, etc.), protective clothes usage, anti-epidemic measures use at different accidents. This approach gave effective results not only in laboratories but also during field work (natural plaque foci investigations, etc.) and at emergencies. Recently in world practice to increase the level of biosafety technical equipment and devices are developed and used very intensively. During training maximal time is paid to their mastering. At such training biosafety practically depends on safe and reliable work of engineer-technical systems. At present in Ukrainian Anti-Plaque Institute with the support of Canadian Government Training Centre on biosafety and biodefense for specialists of Ukraine and FSU countries is being organized. Teaching programs will include complex study of hand manipulations and modern technical means knowledge. To our mind such initial training had to be available for all specialists of BSL 1-2 microbiological laboratories of any subordination. For this goal all kinds of programs will be developed. Such complex approach will promote to decrease biological risks in microbiological laboratories and prevent infectious agents import from working territories.(author)

  8. Evaluating the effectiveness of a logger safety training program.

    Science.gov (United States)

    Bell, Jennifer L; Grushecky, Shawn T

    2006-01-01

    Logger safety training programs are rarely, if ever, evaluated as to their effectiveness in reducing injuries. Workers' compensation claim rates were used to evaluate the effectiveness of a logger safety training program, the West Virginia Loggers' Safety Initiative (LSI). There was no claim rate decline detected in the majority (67%) of companies that participated in all 4 years of the LSI. Furthermore, their rate did not differ from the rest of the WV logging industry that did not participate in the LSI. Worker turnover was significantly related to claim rates; companies with higher turnover of employees had higher claim rates. Companies using feller bunchers to harvest trees at least part of the time had a significantly lower claim rate than companies not using them. Companies that had more inspections per year had lower claim rates. High injury rates persist even in companies that receive safety training; high employee turnover may affect the efficacy of training programs. The logging industry should be encouraged to facilitate the mechanization of logging tasks, to address barriers to employee retention, and to increase the number of in-the-field performance monitoring inspections. Impact on industry There are many states whose logger safety programs include only about 4-8 hours of safe work practices training. These states may look to West Virginia's expanded training program (the LSI) as a model for their own programs. However, the LSI training may not be reaching loggers due to the delay in administering training to new employees and high levels of employee turnover. Regardless of training status, loggers' claim rates decline significantly the longer they work for a company. It may be that high injury rates in the state of West Virginia would be best addressed by finding ways to encourage and facilitate companies to become more mechanized in their harvesting practices, and to increase employee tenure. Increasing the number of yearly performance inspections

  9. Does Warm-Up Training in a Virtual Reality Simulator Improve Surgical Performance? A Prospective Randomized Analysis.

    Science.gov (United States)

    da Cruz, José Arnaldo Shiomi; Dos Reis, Sabrina Thalita; Cunha Frati, Rodrigo Marcus; Duarte, Ricardo Jordão; Nguyen, Hiep; Srougi, Miguel; Passerotti, Carlo Camargo

    was no difference in time for gallbladder removal (11.58 ± 4.31 vs. 15.08 ± 4.51min, p = 0.096), total operative time (30.8 ± 11.07 vs. 25.60 ± 5.10min, p = 0.188), and efficiency (4 ± 0.66 vs. 3.6 ± 0.69, p = 0.320). The practice of preoperative warm-up training seems to benefit surgical performance even in subject with mild laparoscopic experience. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  10. Allied-General operator training program

    International Nuclear Information System (INIS)

    Ayers, A.L.; Ebel, P.E.

    1975-01-01

    All operators at Allied-General Nuclear Services are initially trained in the basic concepts of radiation and radiation protection, they are drilled in the basic technical tools needed for further training, they are instructed in the design and operation of the Barnwell Nuclear Fuel Plant, and they are introduced to the actual operations via operating procedures. This all occurs during the Before-the-Baseline training phase and then the operators move on Beyond-the-Baseline. There they physically learn how to do their job at their own pace using checklists as a guide. All operators are then internally certified. Progression is based on demonstrated ability and those that qualify go on to jobs requiring NRC licenses. Upon internal certification, retraining commences immediately and will continue in its four month, one year, and two year cycles. Current feedback from the various classes that have completed the courses and are now in the retraining program indicates that this combination of initial technical training, on-the-job training, and retraining will produce and maintain effective, safe, and efficient operators

  11. Injuries in women associated with a periodized strength training and running program.

    Science.gov (United States)

    Reynolds, K L; Harman, E A; Worsham, R E; Sykes, M B; Frykman, P N; Backus, V L

    2001-02-01

    Forty-five women participated in a 24-week physical training program designed to improve lifting, load carriage, and running performance. Activities included weightlifting, running, backpacking, lift and carry drills, and sprint running. Physicians documented by passive surveillance all training-related injuries. Thirty-two women successfully completed training program. Twenty-two women (48.9%) suffered least 1 injury during training, but only 2 women had to drop out of the study because of injuries. The rate of injury associated with lost training time was 2.8 injuries per 1,000 training hours of exposure. Total clinic visits and days lost from training were 89 and 69, respectively. Most injuries were the overuse type involving the lower back, knees, and feet. Weightlifting accounted for a majority of the lost training days. A combined strength training and running program resulted in significant performance gains in women. Only 2 out of 45 participants left the training program cause of injuries.

  12. The impact of video games on training surgeons in the 21st century.

    Science.gov (United States)

    Rosser, James C; Lynch, Paul J; Cuddihy, Laurie; Gentile, Douglas A; Klonsky, Jonathan; Merrell, Ronald

    2007-02-01

    Video games have become extensively integrated into popular culture. Anecdotal observations of young surgeons suggest that video game play contributes to performance excellence in laparoscopic surgery. Training benefits for surgeons who play video games should be quantifiable. There is a potential link between video game play and laparoscopic surgical skill and suturing. Cross-sectional analysis of the performance of surgical residents and attending physicians participating in the Rosser Top Gun Laparoscopic Skills and Suturing Program (Top Gun). Three different video game exercises were performed, and surveys were completed to assess past experience with video games and current level of play, and each subject's level of surgical training, number of laparoscopic cases performed, and number of years in medical practice. Academic medical center and surgical training program. Thirty-three residents and attending physicians participating in Top Gun from May 10 to August 24, 2002. The primary outcome measures were compared between participants' laparoscopic skills and suturing capability, video game scores, and video game experience. Past video game play in excess of 3 h/wk correlated with 37% fewer errors (Pvideo game players and 42% better (Pvideo game players made 32% fewer errors (P=.04), performed 24% faster (Pvideo gaming skills, those in the top tertile made 47% fewer errors, performed 39% faster, and scored 41% better (Pvideo game skill and past video game experience are significant predictors of demonstrated laparoscopic skills. Video game skill correlates with laparoscopic surgical skills. Training curricula that include video games may help thin the technical interface between surgeons and screen-mediated applications, such as laparoscopic surgery. Video games may be a practical teaching tool to help train surgeons.

  13. 14 CFR 91.1097 - Pilot and flight attendant crewmember training programs.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Pilot and flight attendant crewmember... RULES Fractional Ownership Operations Program Management § 91.1097 Pilot and flight attendant crewmember training programs. (a) Each program manager must establish and maintain an approved pilot training program...

  14. Forty years of training program in the JAERI

    International Nuclear Information System (INIS)

    1998-03-01

    This report is to compile the past training program of researchers, engineers and regulatory members at the NuTEC (Nuclear Technology and Education Center) of Japan Atomic Energy Research Institute and the past basic seminars for the public, in addition to advice and perspective on the future program from relevant experts, in commemoration of the forty years of the NuTEC. It covers the past five years of educational courses and seminars in utilization of radioisotopes and nuclear energy for domestic and for international training provided at Tokyo and Tokai Education Centers and covers the activity of the Asia-Pacific nuclear technology transfer, including the activity of various committees and meetings. Especially, fifty six experts and authorities have contributed to the report with positive advice and perspective on the training program in the 21st century based on their reminiscences. (author)

  15. 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.

  16. A contemporary analysis of Fournier gangrene using the National Surgical Quality Improvement Program.

    Science.gov (United States)

    Kim, Stanley Y; Dupree, James M; Le, Brian V; Kim, Dae Y; Zhao, Lee C; Kundu, Shilajit D

    2015-05-01

    To determine a nationwide contemporary description of surgical Fournier gangrene (FG) and necrotizing fasciitis of the genitalia (NFG) outcomes because historically reported mortality rates for FG and NFG are based on small single-institution studies from the 1980s and the 1990s. The National Surgical Quality Improvement Program is a risk-adjusted surgical database used by nearly 400 hospitals nationwide, which tracks preoperative, intraoperative, and 30-day postoperative clinical variables. Data are extracted from patient charts by an independent surgical clinical reviewer at each hospital. Using the National Surgical Quality Improvement Program data from 2005 to 2009, we calculated 30-day mortality rates and identified preoperative factors associated with increased mortality. A total of 650 patients were identified with surgery for FG or NFG. Fourteen patients with do not resuscitate orders placed preoperatively were excluded from analyses. For the remaining 636 patients, the overall 30-day mortality was 10.1% (64 of 636). Fifty-seven percent of patients (360 of 636) were men, 70% (446 of 636) were white, and 13% (81 of 636) were African American. Multivariate logistic regression indicated that increased age (odds ratio [OR], 1.041; P = .004), body mass index (OR, 1.045; P <.001), and preoperative white blood cell count (OR, 1.061; P = .001), and decreased platelet count (OR, 0.993; P <.001) were all associated with increased risk of death. We determined a surgical mortality rate for FG-NFG of 10.1%. This rate is about half of historically published estimates and similar to recent studies. The lower rate may indicate improvements in therapy. Increased age, body mass index, and white blood cell count, and decreased platelet count were all associated with an increased risk of 30-day mortality. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    African Journals Online (AJOL)

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

  18. Nuclear Power Reactor simulator - based training program

    International Nuclear Information System (INIS)

    Abdelwahab, S.A.S.

    2009-01-01

    nuclear power stations will continue playing a major role as an energy source for electric generation and heat production in the world. in this paper, a nuclear power reactor simulator- based training program will be presented . this program is designed to aid in training of the reactor operators about the principles of operation of the plant. also it could help the researchers and the designers to analyze and to estimate the performance of the nuclear reactors and facilitate further studies for selection of the proper controller and its optimization process as it is difficult and time consuming to do all experiments in the real nuclear environment.this program is written in MATLAB code as MATLAB software provides sophisticated tools comparable to those in other software such as visual basic for the creation of graphical user interface (GUI). moreover MATLAB is available for all major operating systems. the used SIMULINK reactor model for the nuclear reactor can be used to model different types by adopting appropriate parameters. the model of each component of the reactor is based on physical laws rather than the use of look up tables or curve fitting.this simulation based training program will improve acquisition and retention knowledge also trainee will learn faster and will have better attitude

  19. Tobacco training in clinical social work graduate programs.

    Science.gov (United States)

    Kleinfelder, JoAnn; Price, James H; Dake, Joseph A; Jordan, Timothy R; Price, Joy A

    2013-08-01

    The leading cause of preventable death, in the most vulnerable segments of society, whom social workers often counsel, is cigarette smoking. The purpose of this study was to assess tobacco smoking cessation training in clinical social work programs. A valid 21-item questionnaire was sent to the entire population of 189 clinical graduate social work programs identified by the Council on Social Work Education. A three-wave mailing process was used to maximize the return rate. Directors from 112 clinical social work programs returned completed questionnaires (61 percent). The majority (91 percent) of directors reported having never thought about offering formal smoking cessation training, and only nine of the programs (8 percent) currently provided formal smoking cessation education. The three leading barriers to offering smoking cessation education were as follows: not a priority (60 percent), not enough time (55 percent), and not required by the accrediting body (41 percent). These findings indicate that clinical social work students are not receiving standardized smoking cessation education to assist in improving the well-being of their clients. The national accrediting body for graduate clinical social work programs should consider implementing guidelines for smoking cessation training in the curriculums.

  20. Staff training program of CANDU projects in Saskatoon

    International Nuclear Information System (INIS)

    Huterer, J.

    1996-01-01

    This paper describes the training process for a nuclear project on a new site. When AECL opened a project office Saskatoon, senior management recognized the need for large scale staff training and made the necessary commitments. Two types of training programs were initiated, general and technical. The general training plan included topics related to nuclear project life cycle. Technical training was discipline and task specific. Based on the job descriptions and staff qualifications, technical training requirements were documented for the entire staff. The training strategy was developed and implemented. Detailed records were maintained to monitor the progress, draw conclusions, and plan training for future nuclear facilities. (author)

  1. Program Director Survey: Attitudes Regarding Child Neurology Training and Testing.

    Science.gov (United States)

    Valencia, Ignacio; Feist, Terri B; Gilbert, Donald L

    2016-04-01

    As a result of major clinical and scientific advances and changes in clinical practice, the role of adult neurology training for Child Neurology and Neurodevelopmental Disability (NDD) certification has become controversial. The most recently approved requirements for board eligibility for child neurology and neurodevelopmental disability residents still include 12 months in adult neurology rotations. The objective of this study was to assess United States child neurology and neurodevelopmental disability residency program directors' opinions regarding optimal residency training. The authors developed an 18-item questionnaire and contacted all 80 child neurology and neurodevelopmental disability program directors via e-mail, using SurveyMonkey. A total of 44 program directors responded (55%), representing programs that train 78 categorical and 94 total resident positions, approximately 70% of those filled in the match. Respondents identified multiple areas where child neurology residents need more training, including genetics and neuromuscular disease. A substantial majority (73%) believed child neurology and neurodevelopmental disability residents need less than 12 adult neurology training months; however, most (75%) also believed adult hospital service and man-power needs (55%) and finances (34%) would pose barriers to reducing adult neurology. Most (70%) believed reductions in adult neurology training should be program flexible. A majority believed the written initial certification examination should be modified with more child neurology and fewer basic neuroscience questions. Nearly all (91%) felt the views of child neurology and neurodevelopmental disability program directors are under-represented within the Accreditation Council for Graduate Medical Education Residency Review Committee. The requirement for 12 adult neurology months for Child Neurology and Neurodevelopmental Disability certification is not consistent with the views of the majority of program

  2. Training program for students and young engineers in JMTR

    International Nuclear Information System (INIS)

    Takemoto, Noriyuki; Izumo, Hironobu; Hori, Naohiko; Ishitsuka, Etsuo; Suzuki, Masahide

    2012-01-01

    The JMTR is expected to be a key infrastructure to contribute the nuclear Human Resource Development (HRD) by a research and On-Job-Training (OJT) in order to support global expansion of nuclear power industry. The training program for Asian young researchers and engineers were started from JFY 2011 in JAEA, and ten trainees from Kazakhstan and Thailand had attended in this program in JFY 2011. In addition, in the nuclear HRD initiative program sponsored by the MEXT, the training course was newly established for domestic students and young engineers from JFY 2010 to JFY 2012. In this course, basic understanding on irradiation test and post irradiation examination is aimed to achieve by overall and practical training such as the neutronic/thermal designs of irradiation capsule, post irradiation examination, measurement and evaluation of neutron fluence, etc. using the JMTR and the related facilities. The 1st training course was held with 10 trainees in JFY 2010. The 2nd and 3rd training courses were also held with 19 trainees and 16 trainees in JFY 2011. From JFY 2012, two courses will be held in every year, and 20 trainees will be accepted in each course. (author)

  3. Training program for students and young engineers in JMTR

    Energy Technology Data Exchange (ETDEWEB)

    Takemoto, Noriyuki; Izumo, Hironobu; Hori, Naohiko; Ishitsuka, Etsuo; Suzuki, Masahide [Japan Atomic Energy Agency, Oarai Research and Development Center, Oarai, Ibaraki (Japan)

    2012-03-15

    The JMTR is expected to be a key infrastructure to contribute the nuclear Human Resource Development (HRD) by a research and On-Job-Training (OJT) in order to support global expansion of nuclear power industry. The training program for Asian young researchers and engineers were started from JFY 2011 in JAEA, and ten trainees from Kazakhstan and Thailand had attended in this program in JFY 2011. In addition, in the nuclear HRD initiative program sponsored by the MEXT, the training course was newly established for domestic students and young engineers from JFY 2010 to JFY 2012. In this course, basic understanding on irradiation test and post irradiation examination is aimed to achieve by overall and practical training such as the neutronic/thermal designs of irradiation capsule, post irradiation examination, measurement and evaluation of neutron fluence, etc. using the JMTR and the related facilities. The 1st training course was held with 10 trainees in JFY 2010. The 2nd and 3rd training courses were also held with 19 trainees and 16 trainees in JFY 2011. From JFY 2012, two courses will be held in every year, and 20 trainees will be accepted in each course. (author)

  4. 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

  5. The Rehabilitation Medicine Scientist Training Program

    Science.gov (United States)

    Whyte, John; Boninger, Michael; Helkowski, Wendy; Braddom-Ritzler, Carolyn

    2016-01-01

    Physician scientists are seen as important in healthcare research. However, the number of physician scientists and their success in obtaining NIH funding have been declining for many years. The shortage of physician scientists in Physical Medicine and Rehabilitation is particularly severe, and can be attributed to many of the same factors that affect physician scientists in general, as well as to the lack of well developed models for research training. In 1995, the Rehabilitation Medicine Scientist Training Program (RMSTP) was funded by a K12 grant from the National Center of Medical Rehabilitation Research (NCMRR), as one strategy for increasing the number of research-productive physiatrists. The RMSTP's structure was revised in 2001 to improve the level of preparation of incoming trainees, and to provide a stronger central mentorship support network. Here we describe the original and revised structure of the RMSTP and review subjective and objective data on the productivity of the trainees who have completed the program. These data suggest that RMSTP trainees are, in general, successful in obtaining and maintaining academic faculty positions and that the productivity of the cohort trained after the revision, in particular, shows impressive growth after about 3 years of training. PMID:19847126

  6. 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…

  7. Case-Logging Practices in Otolaryngology Residency Training: National Survey of Residents and Program Directors.

    Science.gov (United States)

    Dermody, Sarah M; Gao, William; McGinn, Johnathan D; Malekzadeh, Sonya

    2017-06-01

    Objective (1) Evaluate the consistency and manner in which otolaryngology residents log surgical cases. (2) Assess the extent of instruction and guidance provided by program directors on case-logging practices. Study Design Cross-sectional national survey. Setting Accreditation Council for Graduate Medical Education otolaryngology residency programs in the United States. Subjects and Methods US otolaryngology residents, postgraduate year 2 through graduating chiefs as of July 2016, were recruited to respond to an anonymous questionnaire designed to characterize surgical case-logging practices. Program directors of US otolaryngology residency programs were recruited to respond to an anonymous questionnaire to elucidate how residents are instructed to log cases. Results A total of 272 residents and 53 program directors completed the survey, yielding response rates of 40.6% and 49.5%, respectively. Perceived accuracy of case logs is low among residents and program directors. Nearly 40% of residents purposely choose not to log certain cases, and 65.1% of residents underreport cases performed. More than 80% of program directors advise residents to log procedures performed outside the operating room, yet only 16% of residents consistently log such cases. Conclusion Variability in surgical case-logging behaviors and differences in provided instruction highlight the need for methods to improve consistency of logging practices. It is imperative to standardize practices across otolaryngology residency programs for case logs to serve as an accurate measure of surgical competency. This study provides a foundation for reform efforts within residency programs and for the Resident Case Log System.

  8. Report of VA Medical Training Programs

    Data.gov (United States)

    Department of Veterans Affairs — The Report of VA Medical Training Programs Database is used to track medical center health services trainees and VA physicians serving as faculty. The database also...

  9. Interactive, Computer-Based Training Program for Radiological Workers

    International Nuclear Information System (INIS)

    Trinoskey, P.A.; Camacho, P.I.; Wells, L.

    2000-01-01

    Lawrence Livermore National Laboratory (LLNL) is redesigning its Computer-Based Training (CBT) program for radiological workers. The redesign represents a major effort to produce a single, highly interactive and flexible CBT program that will meet the training needs of a wide range of radiological workers--from researchers and x-ray operators to individuals working in tritium, uranium, plutonium, and accelerator facilities. The new CBT program addresses the broad diversity of backgrounds found at a national laboratory. When a training audience is homogeneous in terms of education level and type of work performed, it is difficult to duplicate the effectiveness of a flexible, technically competent instructor who can tailor a course to the express needs and concerns of a course's participants. Unfortunately, such homogeneity is rare. At LLNL, they have a diverse workforce engaged in a wide range of radiological activities, from the fairly common to the quite exotic. As a result, the Laboratory must offer a wide variety of radiological worker courses. These include a general contamination-control course in addition to radioactive-material-handling courses for both low-level laboratory (i.e., bench-top) activities as well as high-level work in tritium, uranium, and plutonium facilities. They also offer training courses for employees who work with radiation-generating devices--x-ray, accelerator, and E-beam operators, for instance. However, even with the number and variety of courses the Laboratory offers, they are constrained by the diversity of backgrounds (i.e., knowledge and experience) of those to be trained. Moreover, time constraints often preclude in-depth coverage of site- and/or task-specific details. In response to this situation, several years ago LLNL began moving toward computer-based training for radiological workers. Today, that CBT effort includes a general radiological safety course developed by the Department of Energy's Hanford facility and a

  10. Assessment of surgical competence in North American graduate periodontics programs: a survey of current practices.

    Science.gov (United States)

    Ghiabi, Edmond; Taylor, K Lynn

    2010-08-01

    This cross-sectional study was designed to document the methods utilized by North American graduate periodontics programs in assessing their residents' surgical skills. A survey of clinical skills assessment was mailed to directors of all fifty-eight graduate periodontics programs in Canada and the United States. Thirty-four programs (59 percent) responded. The data collected were analyzed using SPSS version 15.0. The results demonstrate that the most common practice for providing feedback and documenting residents' surgical skills in the programs surveyed was daily one-on-one verbal feedback given by an instructor. The next two most commonly reported methods were a standard checklist developed at program level and a combination of a checklist and verbal comments. The majority of the programs reported that the instructors met collectively once per term to evaluate the residents' progress. The results suggest that graduate periodontics programs provide their residents frequent opportunities for daily practice with verbal feedback from instructors. However, assessment strategies identified in other health professions as beneficial in fostering the integration of clinical skills practices are not employed.

  11. Results of a psychosomatic training program in China, Vietnam and Laos: successful cross-cultural transfer of a postgraduate training program for medical doctors.

    Science.gov (United States)

    Fritzsche, Kurt; Scheib, Peter; Ko, Nayeong; Wirsching, Michael; Kuhnert, Andrea; Hick, Jie; Schüßler, Gerhard; Wu, Wenyuan; Yuan, Shen; Cat, Nguyen Huu; Vongphrachanh, Sisouk; Linh, Ngo Tich; Viet, Ngyuen Kim

    2012-08-29

    With the "ASIA-LINK" program, the European Community has supported the development and implementation of a curriculum of postgraduate psychosomatic training for medical doctors in China, Vietnam and Laos. Currently, these three countries are undergoing great social, economic and cultural changes. The associated psychosocial stress has led to increases in psychological and psychosomatic problems, as well as disorders for which no adequate medical or psychological care is available, even in cities. Health care in these three countries is characterized by the coexistence of Western medicine and traditional medicine. Psychological and psychosomatic disorders and problems are insufficiently recognized and treated, and there is a need for biopsychosocially orientated medical care. Little is known about the transferability of Western-oriented psychosomatic training programs in the Southeast Asian cultural context. The curriculum was developed and implemented in three steps: 1) an experimental phase to build a future teacher group; 2) a joint training program for future teachers and German teachers; and 3) training by Asian trainers that was supervised by German teachers. The didactic elements included live patient interviews, lectures, communication skills training and Balint groups. The training was evaluated using questionnaires for the participants and interviews of the German teachers and the future teachers. Regional training centers were formed in China (Shanghai), Vietnam (Ho Chi Minh City and Hue) and Laos (Vientiane). A total of 200 physicians completed the training, and 30 physicians acquired the status of future teacher. The acceptance of the training was high, and feelings of competence increased during the courses. The interactive training methods were greatly appreciated, with the skills training and self-experience ranked as the most important topics. Adaptations to the cultural background of the participants were necessary for the topics of "breaking bad

  12. Results of a psychosomatic training program in China, Vietnam and Laos: successful cross-cultural transfer of a postgraduate training program for medical doctors

    Directory of Open Access Journals (Sweden)

    Fritzsche Kurt

    2012-08-01

    Full Text Available Abstract Background With the “ASIA-LINK” program, the European Community has supported the development and implementation of a curriculum of postgraduate psychosomatic training for medical doctors in China, Vietnam and Laos. Currently, these three countries are undergoing great social, economic and cultural changes. The associated psychosocial stress has led to increases in psychological and psychosomatic problems, as well as disorders for which no adequate medical or psychological care is available, even in cities. Health care in these three countries is characterized by the coexistence of Western medicine and traditional medicine. Psychological and psychosomatic disorders and problems are insufficiently recognized and treated, and there is a need for biopsychosocially orientated medical care. Little is known about the transferability of Western-oriented psychosomatic training programs in the Southeast Asian cultural context. Methods The curriculum was developed and implemented in three steps: 1 an experimental phase to build a future teacher group; 2 a joint training program for future teachers and German teachers; and 3 training by Asian trainers that was supervised by German teachers. The didactic elements included live patient interviews, lectures, communication skills training and Balint groups. The training was evaluated using questionnaires for the participants and interviews of the German teachers and the future teachers. Results Regional training centers were formed in China (Shanghai, Vietnam (Ho Chi Minh City and Hue and Laos (Vientiane. A total of 200 physicians completed the training, and 30 physicians acquired the status of future teacher. The acceptance of the training was high, and feelings of competence increased during the courses. The interactive training methods were greatly appreciated, with the skills training and self-experience ranked as the most important topics. Adaptations to the cultural background of the

  13. American College of Surgeons NSQIP: quality in-training initiative pilot study.

    Science.gov (United States)

    Sellers, Morgan M; Reinke, Caroline E; Kreider, Susan; Meise, Chelsey; Nelis, Kara; Volpe, Anita; Anzlovar, Nancy; Ko, Clifford; Kelz, Rachel R

    2013-11-01

    Clinical outcomes data are playing an increasingly important role in medical decision-making, reimbursement, and provider evaluation, but there are no documented programs that provide outcomes data to surgical residents as part of a structured curriculum. Our objectives were to develop a national collaborative of training programs to unify the efforts between quality and education personnel and demonstrate the feasibility of generating customized reports of patient outcomes for use in surgical education. The pool of potential hospitals was evaluated by comparing ACS NSQIP participants with the roster of clinical sites for general surgery residency programs maintained by FREIDA Online. A program and user guide was developed to generate custom reports based on institutional data, and a voluntary pilot was conducted, consisting of initial development, implementation, and feedback stages. Programs that successfully completed installation and report generation were queried for feedback on time and resources used. Of 245 general surgery residency programs, 47% had a NSQIP-affiliated sponsor institution, and an additional 31% had at least 1 NSQIP-affiliated participant institution. Sixty general surgery residency programs have expressed interest in collaboration. Seventeen pilot sites completed training and installation, and were able to independently generate custom reports. The response rate for the post-report survey was 50%. Participants reported that training and installation typically required one 2-hour phone call, and that total time devoted to the project was less than 8 hours. Collaboration between educators and quality improvement personnel from a diverse group of organizations to integrate outcomes data into surgical education is feasible. Obtaining resident and team reports from ACS NSQIP can be done with minimal effort. Future efforts will be aimed at developing a national data-centered curriculum for general surgery programs. Copyright © 2013 American

  14. Comparing the outcomes of different postgraduate year training programs in Taiwan

    Directory of Open Access Journals (Sweden)

    Peng-Wei Hsu

    2015-12-01

    Conclusion: A well-designed postgraduate training program should develop trainees’ competencies. The results of this study may provide useful insight for ways to improve the design of training programs. Further investigation to better understand the impact of different programs is warranted.

  15. Psychosocial Training in U.S. Internal Medicine and Family Practice Residency Programs.

    Science.gov (United States)

    Gaufberg, Elizabeth H.; Joseph, Robert C.; Pels, Richard J.; Wyshak, Grace; Wieman, Dow; Nadelson, Carol C.

    2001-01-01

    Surveyed directors of internal medicine (IM) and family practice (FP) residency programs regarding the format, content, and quantity of psychosocial training in their programs, their opinions on topics related to such training, and program demographics. Found considerable variation in content and time devoted to psychosocial training within and…

  16. Continuity of care of emergency surgical admissions: impact on SpR training.

    Science.gov (United States)

    Ledwidge, S F C; Bryden, E; Halestrap, P; Galland, R B

    2008-06-01

    Continuity of patient care is an important component of surgical education. This study assesses continuity of care in the current working climate. Data were collected prospectively on consecutive emergency general surgical admissions during one month. Our SpR rota is a partial shift 24 hour on call with the SpR's own consultant. The SpR is free of commitments the next day following post-take work. The on call general surgery SpR was designated the 'assessor'. Data were analysed according to involvement of the 'assessor' at subsequent stages of the admission--consent, operation, review during admission and review on discharge. Data were also collected defining whether the 'assessor' and operator followed-up the patient. There were 200 admissions; 108 female and 92 male. Overall 23% admissions had the same 'assessor' for all stages of patient care. The 'assessor' dealt with an aspect of patient care in 11% of admissions who underwent an operation and 29% of admissions who were conservatively managed. SpR follow-up of admissions on whom they operated was 70% but only 41% of admissions who were conservatively managed were followed-up by the assessing SpR. Complete in-hospital continuity of care was poor, although SpR follow-up of patients on whom they had operated was better. Introduction of shift patterns has reduced continuity of patient care. This will have a negative impact on both surgical training and patient care.

  17. 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.

  18. Surgical ethics: surgical virtue and more.

    Science.gov (United States)

    Vercler, Christian J

    2015-01-01

    The encounter between a patient and her surgeon is unique for several reasons. The surgeon inflicts pain upon a patient for the patient's own good. An operative intervention is irreducibly personal, such that the decisions about and performance of operations are inseparable from the idiosyncrasies of the individual surgeon. Furthermore, there is a chasm of knowledge between the patient and surgeon that is difficult to cross. Hence, training in the discipline of surgery includes the inculcation of certain virtues and practices to safeguard against abuses of this relationship and to make sure that the best interests of the patient are prioritized. The stories in this issue are evidence that in contemporary practice this is not quite enough, as surgeons reflect on instances they felt were ethically challenging. Common themes include the difficulty in communicating surgical uncertainty, patient-surgeon relationships, ethical issues in surgical training, and the impact of the technological imperative on caring for dying patients.

  19. Procedural specificity in laparoscopic simulator training

    DEFF Research Database (Denmark)

    Bjerrum, Flemming; Sørensen, Jette Led; Konge, Lars

    2014-01-01

    . The secondary outcome is the total training time to proficiency. The improvement in motor skills and effect on cognitive load are also explored. DISCUSSION: The results of this trial might provide new knowledge on how the technical part of surgical training curricula should be comprised in the future......BACKGROUND: The use of structured curricula for minimally invasive surgery training is becoming increasingly popular. However, many laparoscopic training programs still use basic skills and isolated task training, despite increasing evidence to support the use of training models with higher...... functional resemblance, such as whole procedural modules. In contrast to basic skills training, procedural training involves several cognitive skills such as elements of planning, movement integration, and how to avoid adverse events. The objective of this trial is to investigate the specificity...

  20. Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery

    Science.gov (United States)

    Siletz, Anaar E.; Singer, Emily S.; Faltermeier, Claire; Hu, Q. Lina; Ko, Clifford Y.; Golladay, Gregory J.; Kates, Stephen L.; Wick, Elizabeth C.; Maggard-Gibbons, Melinda

    2018-01-01

    Background: Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery—a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty (TKA) and total hip arthroplasty (THA). Study Design: This review focuses on potential components of the protocol relevant to surgeons; anesthesia components are reported separately. Components were identified through review of existing pathways and from consultation with technical experts. For each, a structured review of MEDLINE identified systematic reviews, randomized trials, and observational studies that reported on these components in patients undergoing elective TKA/THA. This primary evidence review was combined with existing clinical guidelines in a narrative format. Results: Sixteen components were reviewed. Of the 10 preoperative components, most were focused on risk factor assessment including anemia, diabetes mellitus, tobacco use, obesity, nutrition, immune-modulating therapy, and opiates. Preoperative education, venous thromboembolism (VTE) prophylaxis, and bathing/Staphylococcus aureus decolonization were also included. The routine use of drains was the only intraoperative component evaluated. The 5 postoperative components included early mobilization, continuous passive motion, extended duration VTE prophylaxis, early oral alimentation, and discharge planning. Conclusion: This review synthesizes the evidence supporting potential surgical components of an ERP for elective TKA/THA. The AHRQ Safety Program for Improving

  1. Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.

    Science.gov (United States)

    Childers, Christopher P; Siletz, Anaar E; Singer, Emily S; Faltermeier, Claire; Hu, Q Lina; Ko, Clifford Y; Golladay, Gregory J; Kates, Stephen L; Wick, Elizabeth C; Maggard-Gibbons, Melinda

    2018-01-01

    Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery-a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty (TKA) and total hip arthroplasty (THA). This review focuses on potential components of the protocol relevant to surgeons; anesthesia components are reported separately. Components were identified through review of existing pathways and from consultation with technical experts. For each, a structured review of MEDLINE identified systematic reviews, randomized trials, and observational studies that reported on these components in patients undergoing elective TKA/THA. This primary evidence review was combined with existing clinical guidelines in a narrative format. Sixteen components were reviewed. Of the 10 preoperative components, most were focused on risk factor assessment including anemia, diabetes mellitus, tobacco use, obesity, nutrition, immune-modulating therapy, and opiates. Preoperative education, venous thromboembolism (VTE) prophylaxis, and bathing/ Staphylococcus aureus decolonization were also included. The routine use of drains was the only intraoperative component evaluated. The 5 postoperative components included early mobilization, continuous passive motion, extended duration VTE prophylaxis, early oral alimentation, and discharge planning. This review synthesizes the evidence supporting potential surgical components of an ERP for elective TKA/THA. The AHRQ Safety Program for Improving Surgical Care and Recovery aims to guide hospitals and

  2. Psychiatry Training in Canadian Family Medicine Residency Programs

    OpenAIRE

    Kates, Nick; Toews, John; Leichner, Pierre

    1985-01-01

    Family physicians may spend up to 50% of their time diagnosing and managing mental disorders and emotional problems, but this is not always reflected in the training they receive. This study of the teaching of psychiatry in the 16 family medicine residency programs in Canada showed that although the majority of program directors are reasonably satisfied with the current training, they see room for improvement—particularly in finding psychiatrists with a better understanding of family practice...

  3. Natural resources youth training program (NRYTP), resource rangers 2010

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-09-15

    In 2010, for a second year, the natural resources youth training program (NRYTP) was developed in northern Manitoba thanks to Manitoba Keewatinowi Okimakanak Inc. (MKO) and the collaboration of 42 sponsors. 16 aboriginal youth representing six northern communities took part in the five-week program located at the Egg Lake camp. The objective was to provide these resources rangers with knowledge and training in the most widespread resource sectors in northern Manitoba, including mining, forestry and hydropower. Trainers and experts provided by industry partners offered training sessions, hands-on work experience and other activities to help resource rangers to acquire a better understanding of the employability in this field in the northern region and the knowledge and skills the resource-based careers require. Life and professional skills training was given by the camp staff and local professionals. On-site elders and cultural events also allowed the integration of a northern Cree cultural component. Three staff members, a cook and elders assisted daily the resource rangers. Many improvements and refinements have been made since the success of the 2009 program, including the involvement of a larger number of communities, program contributors and program graduates. The program length has doubled and the number of jobs created has increased, important cultural aspects were introduced and the overall expenses were reduced.

  4. Teaching-skills training programs for family medicine residents: systematic review of formats, content, and effects of existing programs.

    Science.gov (United States)

    Lacasse, Miriam; Ratnapalan, Savithiri

    2009-09-01

    To review the literature on teaching-skills training programs for family medicine residents and to identify formats and content of these programs and their effects. Ovid MEDLINE (1950 to mid-July 2008) and the Education Resources Information Center database (pre-1966 to mid-July 2008) were searched using and combining the MeSH terms teaching, internship and residency, and family practice; and teaching, graduate medical education, and family practice. The initial MEDLINE and Education Resources Information Center database searches identified 362 and 33 references, respectively. Titles and abstracts were reviewed and studies were included if they described the format or content of a teaching-skills program or if they were primary studies of the effects of a teaching-skills program for family medicine residents or family medicine and other specialty trainees. The bibliographies of those articles were reviewed for unidentified studies. A total of 8 articles were identified for systematic review. Selection was limited to articles published in English. Teaching-skills training programs for family medicine residents vary from half-day curricula to a few months of training. Their content includes leadership skills, effective clinical teaching skills, technical teaching skills, as well as feedback and evaluation skills. Evaluations mainly assessed the programs' effects on teaching behaviour, which was generally found to improve following participation in the programs. Evaluations of learner reactions and learning outcomes also suggested that the programs have positive effects. Family medicine residency training programs differ from all other residency training programs in their shorter duration, usually 2 years, and the broader scope of learning within those 2 years. Few studies on teaching-skills training, however, were designed specifically for family medicine residents. Further studies assessing the effects of teaching-skills training in family medicine residents are

  5. Study of virtual reality application in training programs on nuclear technology

    International Nuclear Information System (INIS)

    Pastura, Valeria da Fonseca e Silva

    2016-01-01

    The activities developed in the units which organize the National Nuclear Energy Commission (CNEN) are present in various sectors of the Brazilian society, being them in medicine, industry, electricity generation, mining, and among the others. Based on the assumption that the employees are CNEN's mayor differential and the training programs play an important role in the process of organizational development, because they align the professionals with the strategies of the institution properly. Focusing on these matters, this master's thesis aimed to evaluate the training programs which are applied by CNEN, in order to propose and evaluate the use of the Virtual Reality (VR) expertise as a new method to be applied in the training programs. To accomplish this purpose, we performed two methodological approaches through questionnaires. And from the analysis of the results obtained, we could realize that there was no efficient training program which is systematically applied by CNEN, and the use of the RV technique improves the training programs in the understanding of themes whose assimilation is challengeable, such as those related to nuclear power. In this sense, for a better functional performance, the training programs adopted by CNEN must be structured so as to enable the development of each server's skills as well as abilities and, it is actually hoped that the virtual reality tools could be inserted in these programs to pursue only this purpose. (author)

  6. Anxiety in veterinary surgical students

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  7. 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.

  8. Patient-specific cardiac phantom for clinical training and preprocedure surgical planning.

    Science.gov (United States)

    Laing, Justin; Moore, John; Vassallo, Reid; Bainbridge, Daniel; Drangova, Maria; Peters, Terry

    2018-04-01

    Minimally invasive mitral valve repair procedures including MitraClip ® are becoming increasingly common. For cases of complex or diseased anatomy, clinicians may benefit from using a patient-specific cardiac phantom for training, surgical planning, and the validation of devices or techniques. An imaging compatible cardiac phantom was developed to simulate a MitraClip ® procedure. The phantom contained a patient-specific cardiac model manufactured using tissue mimicking materials. To evaluate accuracy, the patient-specific model was imaged using computed tomography (CT), segmented, and the resulting point cloud dataset was compared using absolute distance to the original patient data. The result, when comparing the molded model point cloud to the original dataset, resulted in a maximum Euclidean distance error of 7.7 mm, an average error of 0.98 mm, and a standard deviation of 0.91 mm. The phantom was validated using a MitraClip ® device to ensure anatomical features and tools are identifiable under image guidance. Patient-specific cardiac phantoms may allow for surgical complications to be accounted for preoperative planning. The information gained by clinicians involved in planning and performing the procedure should lead to shorter procedural times and better outcomes for patients.

  9. Quantifying surgical complexity with machine learning: looking beyond patient factors to improve surgical models.

    Science.gov (United States)

    Van Esbroeck, Alexander; Rubinfeld, Ilan; Hall, Bruce; Syed, Zeeshan

    2014-11-01

    To investigate the use of machine learning to empirically determine the risk of individual surgical procedures and to improve surgical models with this information. American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data from 2005 to 2009 were used to train support vector machine (SVM) classifiers to learn the relationship between textual constructs in current procedural terminology (CPT) descriptions and mortality, morbidity, Clavien 4 complications, and surgical-site infections (SSI) within 30 days of surgery. The procedural risk scores produced by the SVM classifiers were validated on data from 2010 in univariate and multivariate analyses. The procedural risk scores produced by the SVM classifiers achieved moderate-to-high levels of discrimination in univariate analyses (area under receiver operating characteristic curve: 0.871 for mortality, 0.789 for morbidity, 0.791 for SSI, 0.845 for Clavien 4 complications). Addition of these scores also substantially improved multivariate models comprising patient factors and previously proposed correlates of procedural risk (net reclassification improvement and integrated discrimination improvement: 0.54 and 0.001 for mortality, 0.46 and 0.011 for morbidity, 0.68 and 0.022 for SSI, 0.44 and 0.001 for Clavien 4 complications; P risk for individual procedures. This information can be measured in an entirely data-driven manner and substantially improves multifactorial models to predict postoperative complications. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Advances of NOAA Training Program in Climate Services

    Science.gov (United States)

    Timofeyeva, M. M.

    2012-12-01

    Since 2002, NOAA's National Weather Service (NWS) Climate Services Division (CSD) has offered numerous training opportunities to NWS staff. After eight-years of development, the training program offers three instructor-led courses and roughly 25 online (distance learning) modules covering various climate topics, such as: climate data and observations, climate variability and change, and NWS national / local climate products (tools, skill, and interpretation). Leveraging climate information and expertise available at all NOAA line offices and partners allows for the delivery of the most advanced knowledge and is a very critical aspect of the training program. The emerging NOAA Climate Service (NCS) requires a well-trained, climate-literate workforce at the local level capable of delivering NOAA's climate products and services as well as providing climate-sensitive decision support. NWS Weather Forecast Offices and River Forecast Centers presently serve as local outlets for the NCS climate services. Trained NWS climate service personnel use proactive and reactive approaches and professional education methods in communicating climate variability and change information to local users. Both scientifically-sound messages and amiable communication techniques are important in developing an engaged dialog between the climate service providers and users. Several pilot projects have been conducted by the NWS CSD this past year that apply the program's training lessons and expertise to specialized external user group training. The technical user groups included natural resources managers, engineers, hydrologists, and planners for transportation infrastructure. Training of professional user groups required tailoring instructions to the potential applications for each group of users. Training technical users identified the following critical issues: (1) knowledge of target audience expectations, initial knowledge status, and potential use of climate information; (2) leveraging

  11. Knowing the operative game plan: a novel tool for the assessment of surgical procedural knowledge.

    Science.gov (United States)

    Balayla, Jacques; Bergman, Simon; Ghitulescu, Gabriela; Feldman, Liane S; Fraser, Shannon A

    2012-08-01

    What is the source of inadequate performance in the operating room? Is it a lack of technical skills, poor judgment or a lack of procedural knowledge? We created a surgical procedural knowledge (SPK) assessment tool and evaluated its use. We interviewed medical students, residents and training program staff on SPK assessment tools developed for 3 different common general surgery procedures: inguinal hernia repair with mesh in men, laparoscopic cholecystectomy and right hemicolectomy. The tools were developed as a step-wise assessment of specific surgical procedures based on techniques described in a current surgical text. We compared novice (medical student to postgraduate year [PGY]-2) and expert group (PGY-3 to program staff) scores using the Mann-Whitney U test. We calculated the total SPK score and defined a cut-off score using receiver operating characteristic analysis. In all, 5 participants in 7 different training groups (n = 35) underwent an interview. Median scores for each procedure and overall SPK scores increased with experience. The median SPK for novices was 54.9 (95% confidence interval [CI] 21.6-58.8) compared with 98.05 (95% CP 94.1-100.0) for experts (p = 0.012). The SPK cut-off score of 93.1 discriminates between novice and expert surgeons. Surgical procedural knowledge can reliably be assessed using our SPK assessment tool. It can discriminate between novice and expert surgeons for common general surgical procedures. Future studies are planned to evaluate its use for more complex procedures.

  12. A simulation-based training program improves emergency department staff communication.

    Science.gov (United States)

    Sweeney, Lynn A; Warren, Otis; Gardner, Liz; Rojek, Adam; Lindquist, David G

    2014-01-01

    The objectives of this study were to evaluate the effectiveness of Project CLEAR!, a novel simulation-based training program designed to instill Crew Resource Management (CRM) as the communication standard and to create a service-focused environment in the emergency department (ED) by standardizing the patient encounter. A survey-based study compared physicians' and nurses' perceptions of the quality of communication before and after the training program. Surveys were developed to measure ED staff perceptions of the quality of communication between staff members and with patients. Pretraining and posttraining survey results were compared. After the training program, survey scores improved significantly on questions that asked participants to rate the overall communication between staff members and between staff and patients. A simulation-based training program focusing on CRM and standardizing the patient encounter improves communication in the ED, both between staff members and between staff members and patients.

  13. Middle East Studies Teacher Training Program. Final Report.

    Science.gov (United States)

    Sefein, Naim A.

    This guide presents a teacher training program in Middle Eastern studies and procedures for program implementation. Details concerning program announcement, participant selection, and travel accommodations are included. Participants attended an orientation and registration workshop and an intensive academic workshop before flying to Egypt for the…

  14. Design of training programs for a positive youth development program: Project P.A.T.H.S. in Hong Kong.

    Science.gov (United States)

    Shek, Daniel T L; Chak, Yammy L Y

    2010-01-01

    To facilitate the implementation of the Secondary 1 to Secondary 3 program of the Project P.A.T.H.S. in Hong Kong, systematic training programs are designed for the potential program implementers. The rationales, objectives and design of the Secondary 1 to Secondary 3 training programs are outlined in this paper. The training programs cover theories of adolescent development, positive youth development, background and curricula of the Project P.A.T.H.S., factors affecting program implementation quality and evaluation of the project. Besides introducing the curriculum units, the training programs also focus on nature of learning and related theories (particularly experiential learning), teaching methods and instructional techniques, motivating students, and classroom management.

  15. [Impact of a disaster preparedness training program on health staff].

    Science.gov (United States)

    Parra Cotanda, Cristina; Rebordosa Martínez, Mónica; Trenchs Sainz de la Maza, Victoria; Luaces Cubells, Carles

    2016-09-01

    The aim of this study is to evaluate the effectiveness of a disaster preparedness training program in a Paediatric Emergency Department (PED). A quasi-experimental study was conducted using an anonymous questionnaire that was distributed to health care providers of a PED in a tertiary paediatric hospital. The questions concerned the disaster plan (DP), including theoretical and practical aspects. Questionnaires were distributed and completed in January 2014 (period 1) and November 2014 (period 2). The disaster training program includes theoretical and practical sessions. A total of 110 questionnaires were collected in period 1, and 80 in period 2. Almost three-quarters (71.3%) of PED staff attended the theoretical sessions, and 43.8% attended the practical sessions. The application of this training program significantly improved knowledge about the DP, but no improvement was observed in the practical questions. PED staff felt more prepared to face a disaster after the training program (15.5% vs. 41.8%, Ptraining program improved some knowledge about the disaster plan, but it has not improved responses in practical situations, which may be due to the low attendance at practical sessions and the time between the training program and the questionnaires. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. 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.

  17. Evolution of GPU nuclear's training program

    International Nuclear Information System (INIS)

    Long, R.L.; Coe, R.P.

    1987-01-01

    GPU Nuclear Corporation (GPUN) manages the operators of Three Mile Island Unit 1 and Oyster Creek Nuclear Generating Stations and the recovery activities at the Three Mile Island Unit 2 plant. From the time it was formed in January 1980 GPUN emphasized the use of behavioral learning objectives as the basis for all its training programs. This paper describes the evolution to a formalized performance based Training System Development (TSD) Process. The Training and Education Department staff increased from 10 in 1979 to the current 120 dedicated professionals, with a corresponding increase in facilities and acquisition of sophisticated Basic Principles Training Simulators and a Three Mile Island Unit 1 control Room Replica Simulator. The impact of these developments and achievement of full INPO accreditation are discussed and related to plant performance improvements

  18. Face validation of the Simbionix LAP Mentor virtual reality training module and its applicability in the surgical curriculum

    NARCIS (Netherlands)

    Ayodeji, I. D.; Schijven, M.; Jakimowicz, J.; Greve, J. W.

    2007-01-01

    BACKGROUND: The goal of our study was to determine expert and referent face validity of the LAP Mentor, the first procedural virtual reality (VR) laparoscopy trainer. METHODS: In The Netherlands 49 surgeons and surgical trainees were given a hands-on introduction to the Simbionix LAP Mentor training

  19. An evidence-based virtual reality training program for novice laparoscopic surgeons.

    Science.gov (United States)

    Aggarwal, Rajesh; Grantcharov, Teodor P; Eriksen, Jens R; Blirup, Dorthe; Kristiansen, Viggo B; Funch-Jensen, Peter; Darzi, Ara

    2006-08-01

    To develop an evidence-based virtual reality laparoscopic training curriculum for novice laparoscopic surgeons to achieve a proficient level of skill prior to participating in live cases. Technical skills for laparoscopic surgery must be acquired within a competency-based curriculum that begins in the surgical skills laboratory. Implementation of this program necessitates the definition of the validity, learning curves and proficiency criteria on the training tool. The study recruited 40 surgeons, classified into experienced (performed >100 laparoscopic cholecystectomies) or novice groups (<10 laparoscopic cholecystectomies). Ten novices and 10 experienced surgeons were tested on basic tasks, and 11 novices and 9 experienced surgeons on a procedural module for dissection of Calot triangle. Performance of the 2 groups was assessed using time, error, and economy of movement parameters. All basic tasks demonstrated construct validity (Mann-Whitney U test, P < 0.05), and learning curves for novices plateaued at a median of 7 repetitions (Friedman's test, P < 0.05). Expert surgeons demonstrated a learning rate at a median of 2 repetitions (P < 0.05). Performance on the dissection module demonstrated significant differences between experts and novices (P < 0.002); learning curves for novice subjects plateaued at the fourth repetition (P < 0.05). Expert benchmark criteria were defined for validated parameters on each task. A competency-based training curriculum for novice laparoscopic surgeons has been defined. This can serve to ensure that junior trainees have acquired prerequisite levels of skill prior to entering the operating room, and put them directly into practice.

  20. Doctorate Program Trains Industrial Chemists.

    Science.gov (United States)

    Chemical and Engineering News, 1982

    1982-01-01

    The University of Texas (Dallas) has initiated a new Ph.D. program specifically to train chemists for doctoral level work in industry (Doctor of Chemistry). Participants will complete three research practica (at an industrial site and in two laboratory settings) instead of the traditional dissertation, emphasizing breadth and flexibility in…

  1. 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.

  2. What proportion of basic surgical trainees continue in a surgical career? A survey of the factors which are important in influencing career decisions.

    Science.gov (United States)

    Richards, J M J; Drummond, R; Murray, J; Fraser, S; MacDonald, A; Parks, R W

    2009-10-01

    Since the launch of Modernising Medical Careers, trainees are selected for a run-through training programme in a single surgical specialty. The surgical training bodies are currently considering the recommendations of the Tooke report as they review the policy for selection into surgical training in the UK. There is little information available on the factors involved in career choices amongst surgical trainees and this study aimed to address this issue. Trainees appointed to the Basic Surgical Training Programmes in the west and south-east of Scotland (1996-2006) were contacted by email and invited to participate in an online survey. Of 467 trainees identified, valid email addresses were available for 299 of which 191 (64%) responded to the survey. One hundred and forty-nine (78%) trainees were still working in surgery but 38 (20%) had moved to a non-surgical specialty and 4 (2%) had left the medical profession. Of those who had obtained a NTN at the time of the survey (n = 138), 62 (45%) had a NTN in the specialty they chose at the start of the BST but 34 (25%) had changed to a different surgical specialty and 42 (30%) had left surgery altogether. For those still working in surgery, enjoyment of the specialty was the most important factor affecting career choice. Achieving an acceptable work/life balance was the most significant factor influencing trainees who left surgery. The majority of trainees recruited to surgery at an early stage change specialty or leave surgery altogether. Both social and professional factors are important in career choices. The findings of this study support a period of core surgical training to provide flexibility prior to further training in a surgical specialty.

  3. Balancing Privacy and Professionalism: A Survey of General Surgery Program Directors on Social Media and Surgical Education.

    Science.gov (United States)

    Langenfeld, Sean J; Vargo, Daniel J; Schenarts, Paul J

    Unprofessional behavior is common among surgical residents and faculty surgeons on Facebook. Usage of social media outlets such as Facebook and Twitter is growing at exponential rates, so it is imperative that surgery program directors (PDs) focus on professionalism within social media, and develop guidelines for their trainees and surgical colleagues. Our study focuses on the surgery PDs current approach to online professionalism within surgical education. An online survey of general surgery PDs was conducted in October 2015 through the Association for Program Directors in Surgery listserv. Baseline PD demographics, usage and approach to popular social media outlets, existing institutional policies, and formal curricula were assessed. A total of 110 PDs responded to the survey (110/259, 42.5% response rate). Social media usage was high among PDs (Facebook 68% and Twitter 40%). PDs frequently viewed the social media profiles of students, residents, and faculty. Overall, 11% of PDs reported lowering the rank or completely removing a residency applicant from the rank order list because of online behavior, and 10% reported formal disciplinary action against a surgical resident because of online behavior. Overall, 68% of respondents agreed that online professionalism is important, and that residents should receive instruction on the safe use of social media. However, most programs did not have formal didactics or known institutional policies in place. Use of social media is high among PDs, and they often view the online behavior of residency applicants, surgical residents, and faculty surgeons. Within surgical education, there needs to be an increased focus on institutional policies and standardized curricula to help educate physicians on social media and online professionalism. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  4. 25 CFR 26.29 - What is the scope of the Job Training Program?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What is the scope of the Job Training Program? 26.29 Section 26.29 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES JOB PLACEMENT AND TRAINING PROGRAM Training Services § 26.29 What is the scope of the Job Training Program? A...

  5. Gender and racial training gaps in Oregon apprenticeship programs

    OpenAIRE

    Berik, Günseli; Bilginsoy, Cihan; Williams, Larry S.

    2008-01-01

    This paper uses micro data from Oregon to measure the gender and minority training gaps in apprenticeship training. Its methodological innovation is the use of on-the-job training credit hours of exiting workers as the measure of the quantity of training. Apprentices who started training between 1991 and 2002 are followed through 2007. Controlling for individual and program attributes, women and racial/ethnic minorities on average receive less training than men and whites, respectively. Union...

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

    Science.gov (United States)

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

    2016-01-01

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

  7. History and Outcomes of 50 Years of Physician-Scientist Training in Medical Scientist Training Programs.

    Science.gov (United States)

    Harding, Clifford V; Akabas, Myles H; Andersen, Olaf S

    2017-10-01

    Physician-scientists are needed to continue the great pace of recent biomedical research and translate scientific findings to clinical applications. MD-PhD programs represent one approach to train physician-scientists. MD-PhD training started in the 1950s and expanded greatly with the Medical Scientist Training Program (MSTP), launched in 1964 by the National Institute of General Medical Sciences (NIGMS) at the National Institutes of Health. MD-PhD training has been influenced by substantial changes in medical education, science, and clinical fields since its inception. In 2014, NIGMS held a 50th Anniversary MSTP Symposium highlighting the program and assessing its outcomes. In 2016, there were over 90 active MD-PhD programs in the United States, of which 45 were MSTP supported, with a total of 988 trainee slots. Over 10,000 students have received MSTP support since 1964. The authors present data for the demographic characteristics and outcomes for 9,683 MSTP trainees from 1975-2014. The integration of MD and PhD training has allowed trainees to develop a rigorous foundation in research in concert with clinical training. MSTP graduates have had relative success in obtaining research grants and have become prominent leaders in many biomedical research fields. Many challenges remain, however, including the need to maintain rigorous scientific components in evolving medical curricula, to enhance research-oriented residency and fellowship opportunities in a widening scope of fields targeted by MSTP graduates, to achieve greater racial diversity and gender balance in the physician-scientist workforce, and to sustain subsequent research activities of physician-scientists.

  8. Child Welfare Training in Child Psychiatry Residency: A Program Director Survey

    Science.gov (United States)

    Lee, Terry G.; Cox, Julia R.; Walker, Sarah C.

    2013-01-01

    Objective: This study surveys child psychiatry residency program directors in order to 1) characterize child welfare training experiences for child psychiatry residents; 2) evaluate factors associated with the likelihood of program directors' endorsing the adequacy of their child welfare training; and 3) assess program directors'…

  9. Impact of a surgical site infection (SSI) surveillance program in orthopedics and traumatology.

    Science.gov (United States)

    Mabit, C; Marcheix, P S; Mounier, M; Dijoux, P; Pestourie, N; Bonnevialle, P; Bonnomet, F

    2012-10-01

    Surveillance of surgical site infections (SSI) is a priority. One of the fundamental principles for the surveillance of SSI is based on receiving effective field feedback (retro-information). The aim of this study was to report the results of a program of SSI surveillance and validate the hypothesis that there is a correlation between creating a SSI surveillance program and a reduction in SSI. The protocol was based on the weekly collection of surveillance data obtained directly from the different information systems in different departments. A delay of 3 months was established before extraction and analysis of data and information from the surgical teams. The NNIS index (National Nosocomial Infections Surveillance System) developed by the American surveillance system and the reduction of length of hospital stay index Journées d'hospitalisation évitées (JHE). Since the end of 2009, 7156 surgical procedures were evaluated (rate of inclusion 97.3%), and 84 SSI were registered with a significant decrease over time from 1.86% to 0.66%. A total of 418 days of hospitalization have been saved since the beginning of the surveillance system. Our surveillance system has three strong points: follow-up is continuous, specifically adapted to orthopedic traumatology and nearly exhaustive. The extraction of data directly from hospital information systems effectively improves the collection of data on surgical procedures. The implementation of a SSI surveillance protocol reduces SSI. Level III. Prospective study. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  10. A Consortium Approach to Surgical Education in a Developing Country: Educational Needs Assessment.

    Science.gov (United States)

    Cook, Mackenzie; Howard, Benjamin M; Yu, Angela; Grey, Douglas; Hofmann, Paul B; Moren, Alexis M; Mchembe, Mabula; Essajee, Abbas; Mndeme, Omari; Peck, James; Schecter, William P

    2015-11-01

    Surgical disease is a global health priority, and improving surgical care requires local capacity building. Single-institution partnerships and surgical missions are logistically limited. The Alliance for Global Clinical Training (hereafter the Alliance) is a consortium of US surgical departments that aims to provide continuous educational support at the Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania (MUHAS). To our knowledge, the Alliance is the first multi-institutional international surgical collaboration to be described in the literature. To assess if the Alliance is effectively responding to the educational needs of MUHAS and Muhimbili National Hospital surgeons. During an initial 13-month program (July 1, 2013, to August 31, 2014), faculty and resident teams from 3 US academic surgical programs rotated at MUHAS as physicians and teachers for 1 month each. To assess the value of the project, we administered anonymous surveys. Anonymous surveys were analyzed on a 5-point Likert-type scale. Free-text answers were analyzed for common themes. During the study period, Alliance members were present at MUHAS for 8 months (1 month each). At the conclusion of the first year of collaboration, 15 MUHAS faculty and 22 MUHAS residents completed the survey. The following 6 areas of educational needs were identified: formal didactics, increased clinical mentorship, longer-term Alliance presence, equitable distribution of teaching time, improved coordination and language skills, and reciprocal exchange rotations at US hospitals. The MUHAS faculty and residents agreed that Alliance members contributed to improved patient care and resident education. A multi-institutional international surgical partnership is possible and leads to perceived improvements in patient care and resident learning. Alliance surgeons must continue to focus on training Tanzanian surgeons. Improving the volunteer surgeons' Swahili-language skills would be an asset. Future

  11. Blended learning: strengths, challenges, and lessons learned in an interprofessional training program.

    Science.gov (United States)

    Lotrecchiano, G R; McDonald, P L; Lyons, L; Long, T; Zajicek-Farber, M

    2013-11-01

    This field report outlines the goals of providing a blended learning model for an interdisciplinary training program for healthcare professionals who care for children with disabilities. The curriculum blended traditional face-to-face or on-site learning with integrated online interactive instruction. Credit earning and audited graduate level online coursework, community engagement experiences, and on-site training with maternal and child health community engagement opportunities were blended into a cohesive program. The training approach emphasized adult learning principles in different environmental contexts integrating multiple components of the Leadership Education in Neurodevelopmental and Related Disabilities Program. This paper describes the key principles adopted for this blended approach and the accomplishments, challenges, and lessons learned. The discussion offers examples from training content, material gathered through yearly program evaluation, as well as university course evaluations. The lessons learned consider the process and the implications for the role of blended learning in this type of training program with suggestions for future development and adoption by other programs.

  12. Challenges to the development of complex virtual reality surgical simulations.

    Science.gov (United States)

    Seymour, N E; Røtnes, J S

    2006-11-01

    Virtual reality simulation in surgical training has become more widely used and intensely investigated in an effort to develop safer, more efficient, measurable training processes. The development of virtual reality simulation of surgical procedures has begun, but well-described technical obstacles must be overcome to permit varied training in a clinically realistic computer-generated environment. These challenges include development of realistic surgical interfaces and physical objects within the computer-generated environment, modeling of realistic interactions between objects, rendering of the surgical field, and development of signal processing for complex events associated with surgery. Of these, the realistic modeling of tissue objects that are fully responsive to surgical manipulations is the most challenging. Threats to early success include relatively limited resources for development and procurement, as well as smaller potential for return on investment than in other simulation industries that face similar problems. Despite these difficulties, steady progress continues to be made in these areas. If executed properly, virtual reality offers inherent advantages over other training systems in creating a realistic surgical environment and facilitating measurement of surgeon performance. Once developed, complex new virtual reality training devices must be validated for their usefulness in formative training and assessment of skill to be established.

  13. 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.

  14. Community Building Services Training Program: A Model Training Program to Provide Technical Training for Minority Adults in Construction, Building Maintenance,and Property Management. Final Report.

    Science.gov (United States)

    Community Building Maintenance Corp., Chicago, IL.

    A demonstration program, administered by a community based building maintenance, management, and construction corporation, was developed to provide technical training for minority adults in construction, building maintenance, and property management in the Chicago area. The program was concerned with seeking solutions to the lack of housing, job…

  15. Development of a Training Program for Commercial Building Technicians

    Energy Technology Data Exchange (ETDEWEB)

    Rinholm, Rod

    2013-05-31

    This project focused on developing and deploying a comprehensive program of 22 training modules, including certification requirements, and accreditation standards for commercial building technicians, to help achieve the full savings potential of energy efficient buildings, equipment, and systems. This curriculum extended the currently available commercial building technician programs -- training a labor force in a growing market area focused on energy efficiency. The program helps to remove a major market impediment to low energy/zero energy commercial building system acceptance, namely a lack of operating personnel capable of handling more complex high efficiency systems. The project developed a training curriculum for commercial building technicians, with particular focus on high-efficiency building technology, and systems. In Phase 1, the project team worked collaboratively in developing a draft training syllabus to address project objectives. The team identified energy efficiency knowledge gaps in existing programs and plans and plans to address the gaps with either modified or new curricula. In Phase 2, appropriate training materials were developed to meet project objectives. This material was developed for alternative modes of delivery, including classroom lecture materials, e-learning elements, video segments, exercises, and hands-on training elements. A Certification and Accreditation Plan and a Commercialization and Sustainability Plan were also investigated and developed. The Project Management Plan was updated quarterly and provided direction on the management approaches used to accomplish the expected project objectives. GTI project management practices tightly coordinate project activities using management controls to deliver optimal customer value. The project management practices include clear scope definition, schedule/budget tracking, risk/issue resolution and team coordination.

  16. Training Veterans to Provide Peer Support in a Weight-Management Program: MOVE!

    Science.gov (United States)

    Haynes-Maslow, Lindsey; Carr, Carol; Orr, Melinda; Kahwati, Leila C.; Weiner, Bryan J.; Kinsinger, Linda

    2013-01-01

    Introduction The Veterans Health Administration (VHA) has implemented MOVE!, a weight-management program for veterans designed to address the increasing proportion of overweight and obese veterans. The objective of our study was to determine whether peer support employing motivational interviewing (MI) could positively influence lifestyle changes, thus expanding the reach of the MOVE! program. We describe the initial evaluation of the peer training program. Methods We developed an MI peer counselor training program for volunteer veterans, the “Buddies” program, to provide one-on-one telephone support for veterans enrolled in MOVE!. Buddies were recruited at 5 VHA sites and trained to provide peer support for the 6-month MOVE! intervention. We used a DVD to teach MI skills and followed with 2 to 3 booster sessions. We observed training, conducted pre- and posttraining surveys, and debriefed focus groups to assess training feasibility. Results Fifty-six Buddies were trained. Results indicate positive receipt of the program (89% reported learning about peer counseling and 87% reported learning communication skills). Buddies showed a small improvement in MI self-efficacy on posttraining surveys. We also identified key challenges to learning MI and training implementation. Conclusions MI training is feasible to implement and acceptable to volunteer Buddies. Trainers must assess how effectively volunteers learn MI skills in order to enhance its effective use in health promotion. PMID:24199738

  17. Evaluating Security Assistance Programs: Performance Evaluation and the Expanded International Military Education and Training (E-IMET) Program

    National Research Council Canada - National Science Library

    Calhoun, Todd

    1998-01-01

    In 1991 the International Military Education and Training (IMET) program was expanded to include training programs focusing on civilian control over the military, respect for human rights, and responsible defense resource management...

  18. Subspeciality training in hematology and oncology, 2003: results of a survey of training program directors conducted by the American Society of Hematology.

    Science.gov (United States)

    Todd, Robert F; Gitlin, Scott D; Burns, Linda J

    2004-06-15

    A survey of directors of adult and pediatric hematology/oncology subspecialty training programs in the United States and Canada was conducted to assess the environment in which recruitment and training is conducted in these medical disciplines. A total of 107 program directors responded to the survey, representing 66% of internal medicine and 47% of pediatric subspecialty programs in hematology or hematology/oncology. Specific areas covered in the web-based questionnaire included the type and demographics of the training program, profile of the training program director, characteristics of the applicant pool and existing trainee recruits, characteristics of the training program environment and curricula, research productivity of trainees, and the career pathways taken by recent training program graduates (including dominant areas of clinical interest). The results of this survey show considerable heterogeneity in the recruiting practices and the environment in which subspecialty training occurs, leading the authors to recommend improvements in or a heightened attention to issues, including recruitment of minority trainees, flexibility to recruit international medical school graduates, timing of trainee acceptance, maintaining the financial support of Medicare graduation medical education (GME), training of physician scientists, organization of the continuity clinic experience, visibility of nonmalignant hematology as a career path, and level of training program director support.

  19. Paediatric cardiopulmonary resuscitation training program in Latin-America: the RIBEPCI experience

    OpenAIRE

    L?pez-Herce, Jes?s; Matamoros, Martha M.; Moya, Luis; Almonte, Enma; Coronel, Diana; Urbano, Javier; Carrillo, ?ngel; del Castillo, Jimena; Menc?a, Santiago; Moral, Ram?n; Ordo?ez, Flora; S?nchez, Carlos; Lagos, Lina; Johnson, Mar?a; Mendoza, Ovidio

    2017-01-01

    Background To describe the design and to present the results of a paediatric and neonatal cardiopulmonary resuscitation (CPR) training program adapted to Latin-America. Methods A paediatric CPR coordinated training project was set up in several Latin-American countries with the instructional and scientific support of the Spanish Group for Paediatric and Neonatal CPR. The program was divided into four phases: CPR training and preparation of instructors; training for instructors; supervised tea...

  20. 49 CFR 1552.23 - Security awareness training programs.

    Science.gov (United States)

    2010-10-01

    ... employee to identify— (i) Uniforms and other identification, if any are required at the flight school, for... SECURITY ADMINISTRATION, DEPARTMENT OF HOMELAND SECURITY CIVIL AVIATION SECURITY FLIGHT SCHOOLS Flight School Security Awareness Training § 1552.23 Security awareness training programs. (a) General. A flight...

  1. INFLUENCE OF STRENGTH TRAINING PROGRAM ON ISOMETRIC MUSCLE STRENGTH IN YOUNG ATHLETES

    Directory of Open Access Journals (Sweden)

    Dragan Radovanovic

    2007-10-01

    Full Text Available Strength training, or resistance training, is a form of physical conditioning used to increase the ability to resist force. Since muscular strength is required for success in many sports, it is logical to assume that stronger and more powerful young athletes will achieve better results. The aim of the study was to examine the effects of strength training on young athletes. An eight-week strength training program for developing muscle strength was performed in this study. Training protocol was designed specifically for young adolescent’s athletes. The program consisted of exercises for lower and upper body, abdominal and lower back muscles. The programs did not involve the maximal (1-3 repetitions maximum and other very hard intensity exercises that may had negative effect on young athletes. The results showed that strength training program had positive effects on maximal isometric muscle force (Fmax and motor skill. The increase presents the combined influence of strength training and growth.

  2. Reiki training for caregivers of hospitalized pediatric patients: a pilot program.

    Science.gov (United States)

    Kundu, Anjana; Dolan-Oves, Rebecca; Dimmers, Martha A; Towle, Cara B; Doorenbos, Ardith Z

    2013-02-01

    To explore the feasibility of a Reiki therapy-training program for the caregivers of pediatric medical or oncology inpatients, at a large pediatric hospital, a series of Reiki training classes were offered by a Reiki Master. At completion of the training, an interview was conducted to elicit participant's feedback regarding the effectiveness and feasibility of the training program. Seventeen of the 18 families agreed to participate. Most families (65%) attended three Reiki training sessions, reporting that Reiki benefitted their child by improving their comfort (76%), providing relaxation (88%), and pain relief (41%). All caregivers identified becoming an active participant in their child's care as a major gain from participation in the Reiki training. A hospital-based Reiki training program for caregivers of hospitalized pediatric patients is feasible and can positively impact patients and their families. More rigorous research regarding the benefits of Reiki in the pediatric population is needed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Review of Current Aircrew Coordination Training Program and Master Plan for Program Enhancement: Aircrew Coordination Training Master Plan

    National Research Council Canada - National Science Library

    Grubb, G

    2001-01-01

    ...) program to develop a master plan of continuous improvement. Research source materials included policies, training courseware, evaluation guides, research papers and reports, and assessment summaries of operational trend data...

  4. Short radiological emergency response training program

    International Nuclear Information System (INIS)

    Williams, R.D.; Greenhouse, N.A.

    1977-01-01

    This paper presents an outline of a radiological emergency response training program conducted at Brookhaven National Laboratory by the health physics and safety training staff. This course is given to groups from local, county, state, and federal agencies and industrial organizations. It is normally three days in length, although the structure is flexible to accommodate individual needs and prior training. An important feature of the course is an emergency exercise utilizing a short lived radionuclide to better simulate real accident conditions. Groups are encouraged to use their own instruments to gain better familiarity with their operating characteristics under field conditions. Immediately following the exercise, a critical review of the students' performance is conducted

  5. Balance Changes in Trained and Untrained Elderly Undergoing a Five-Months Multicomponent Training Program

    Directory of Open Access Journals (Sweden)

    Ana Cordellat

    2016-10-01

    Full Text Available Balance is a main focus of elderly activity programs which can be assessed by functional tests or stabilometry platforms. Our study aims to compare balance-changes in trained (TRA and untrained (UNT elderly following a 5-month Multi-Component Training Program (MCTP, twice a week, one hour per day. 10 TRA (>2-years and 9 UNT (first year performed the Romberg´s test (Open-Eyes 30 seconds/Closed-Eyes 30 seconds ratio on a stabilometry platform (BT4, Hur Labs. COP displacement (Trace Length: TL and sway area (C90 were registered twice PRE (1&2, POST (3&4 and 3 months later (Detraining: 5&6 the EFAM-UV© program, a Cognitive MCTP based on gait training and Dual-Task neuromuscular proposals in enriched environments. Regarding Open-Eyes, Bonferroni post-hoc comparisons showed significant group-differences in TL for 1, 2, 5 & 6 sample conditions, and a slight trend toward significance in C90 1&5. TL also showed significant group-differences in Closed-Eyes 1, 5 & 6, while C90 only in 5 & 6 Closed-Eyes. Balance indicators TL and C90 show a different way regarding the training status. A 5-month MCTP reduces differences, but detraining quickly affects UNT. Although effective, short multicomponent interventions could lead to early worsening, so the ratio training-detraining might be considered in untrained elderly population.

  6. The Benefits of High-Intensity Functional Training Fitness Programs for Military Personnel.

    Science.gov (United States)

    Haddock, Christopher K; Poston, Walker S C; Heinrich, Katie M; Jahnke, Sara A; Jitnarin, Nattinee

    2016-11-01

    High intensity functional training (HIFT) programs are designed to address multiple fitness domains, potentially providing improved physical and mental readiness in a changing operational environment. Programs consistent with HIFT principals such as CrossFit, SEALFIT and the US Marine Corps' High Intensity Tactical Training (HITT) are increasingly popular among military personnel. The goal of HIFT programs is to produce high levels of cardiorespiratory fitness, endurance and strength that exceed those achieved by following current physical activity recommendations. Given the investment in and popularity of HIFT in the military, it is important to consider the potential impact of this approach to fitness training for the health of military personnel and their risk of training injury. In a previous report in this journal, we addressed the question of whether HIFT was associated with higher injury rates compared to other exercise programs. We argued that concerns about the injury potential of HIFT exercise programs were not supported by the scientific literature to date, although additional research was needed to directly compare injury rates in approaches such as CrossFit to traditional military fitness programs. In this article we will review the scientific data on the practical, health and fitness benefits of HIFT exercise programs for military populations. Practical benefits to HIFT exercise programs include shorter training times and volumes, exercises which simulate combat tasks, lower equipment costs, reduced potential for boredom and adaptation as a result of constant variation, less injury potential compared to high volume endurance training, and scalability to all fitness levels and rehabilitation needs. For instance, HIFT training volumes are typically between 25% to nearly 80% less than traditional military fitness programs without reductions in fitness outcomes. HIFT program also provide an impressive range of health benefits such as the promotion of

  7. Current Techniques of Teaching and Learning in Bariatric Surgical Procedures: A Systematic Review.

    Science.gov (United States)

    Kaijser, Mirjam; van Ramshorst, Gabrielle; van Wagensveld, Bart; Pierie, Jean-Pierre

    The gastric sleeve resection and gastric bypass are the 2 most commonly performed bariatric procedures. This article provides an overview of current teaching and learning methods of those techniques in resident and fellow training. A database search was performed on Pubmed, Embase, and the Education Resources Information Center (ERIC) to identify the methods used to provide training in bariatric surgery worldwide. After exclusion based on titles and abstracts, full texts of the selected articles were assessed. Included articles were reviewed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. In total, 2442 titles were identified and 14 full text articles met inclusion criteria. Four publications described an ex vivo training course, and 6 focused on at least 1 step of the gastric bypass procedure. Two randomized controlled trials (RCT) provided high-quality evidence on training aspects. Surgical coaching caused significant improvement of Bariatric Objective Structured Assessment of Technical Skills (BOSATS) scores (3.60 vs. 3.90, p = 0.017) and reduction of technical errors (18 vs. 10, p = 0.003). A preoperative warm-up increased global rating scales (GRS) scores on depth perception (p = 0.02), bimanual dexterity (p = 0.01), and efficiency of movements (p = 0.03). Stepwise education, surgical coaching, warming up, Internet-based knowledge modules, and ex vivo training courses are effective in relation to bariatric surgical training of residents and fellows, possibly shortening their learning curves. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  8. Simulators and virtual reality in surgical education.

    Science.gov (United States)

    Chou, Betty; Handa, Victoria L

    2006-06-01

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

  9. 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.

  10. 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.

  11. Variability of ethics education in laboratory medicine training programs: results of an international survey.

    Science.gov (United States)

    Bruns, David E; Burtis, Carl A; Gronowski, Ann M; McQueen, Matthew J; Newman, Anthony; Jonsson, Jon J

    2015-03-10

    Ethical considerations are increasingly important in medicine. We aimed to determine the mode and extent of teaching of ethics in training programs in clinical chemistry and laboratory medicine. We developed an on-line survey of teaching in areas of ethics relevant to laboratory medicine. Reponses were invited from directors of training programs who were recruited via email to leaders of national organizations. The survey was completed by 80 directors from 24 countries who directed 113 programs. The largest numbers of respondents directed postdoctoral training of scientists (42%) or physicians (33%), post-masters degree programs (33%), and PhD programs (29%). Most programs (82%) were 2years or longer in duration. Formal training was offered in research ethics by 39%, medical ethics by 31%, professional ethics by 24% and business ethics by 9%. The number of reported hours of formal training varied widely, e.g., from 0 to >15h/year for research ethics and from 0 to >15h for medical ethics. Ethics training was required and/or tested in 75% of programs that offered training. A majority (54%) of respondents reported plans to add or enhance training in ethics; many indicated a desire for online resources related to ethics, especially resources with self-assessment tools. Formal teaching of ethics is absent from many training programs in clinical chemistry and laboratory medicine, with heterogeneity in the extent and methods of ethics training among the programs that provide the training. A perceived need exists for online training tools, especially tools with self-assessment components. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Exploratory study of the radiation-protection training programs in nuclear power plants

    International Nuclear Information System (INIS)

    Fields, C.D.

    1982-06-01

    The objective of the study was to examine current radiation training programs at a sample of utilities operating nuclear reactors and to evaluate employee information on radiation health. The study addressed three elements: (1) employee perceptions and understanding of ionizing radiation; (2) utility trainers-their background, training, and problems; (3) the content, materials, and conduct of training programs; (4) program uniformity and completeness. These areas were examined through visits to utilities, surveys, and employee interviews. The programs reviewed were developed by utility personnel who have backgrounds, for the most part, in health physics but who may have little formal training in adult education. This orientation, coupled with the inherent nature of the subject, has produced training programs that appear to be too technical to achieve the educational job intended. The average nuclear power plant worker does not have the level of sophistication needed to understand some of the information. It became apparent that nuclear power plant workers have concerns that do not necessarily reflect those of the scientific community. Many of these result from misunderstandings about radiation. Unfortunately, the training programs do not always address these unfounded but very real fears

  13. 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.

  14. Energy Assurance Technical Training and Awareness Program/Energy Infrastructure Training and Analysis Center

    Energy Technology Data Exchange (ETDEWEB)

    Barbara McCabe

    2005-11-15

    This report covers the work completed during Year One (Year One has a 16 month project period) of a five- year Cooperative Agreement (DE-FC26-03NT41895) between the International Union of Operating Engineers (IUOE) National Hazmat Program (OENHP) and the U. S. Department of Energy (DOE) National Energy Technology Laboratory (NETL). This final technical report is being submitted, as required by the Cooperative Agreement, within 90 (calendar) days after the project period ends (December 31, 2004). The resources allocated to Year One of the Cooperative Agreement were adequate for the completion of the required deliverables. All deliverables have been completed and sent to AAD Document Control as directed in the cooperative agreement. The allocation for Year One required 20-25 trainers to be trained in each of five Train-the-Trainer courses and a total of 6,000 workers trained throughout the country. Through cost savings employed for the scheduling and conduct of Train-the-Trainer, instructor refreshers, and direct training classes, 3171 workers have been trained to date. This total incorporates 159 trainers and members from management, local, county, state and federal organizations identified in the Strategic Plan. The largest percentage of personnel trained is heavy equipment operators, and building engineers, which is the largest targeted population identified under this cooperative agreement. The OENHP, using existing curriculum as appropriate, has modified and developed new training modules that have been used to establish four different levels of training courses. The four courses are: (1) EA 500 Energy Assurance Train-the-Trainer, (2) EA 400 Energy Assurance Instructor Refresher, (3) EA 300 Energy Assurance, and (4) EA 100 Energy Assurance Awareness. Training modules cover topics, such as, but not limited to, facility vulnerability and vulnerability assessment, physical security- heating, ventilation, air conditioning, terrorism awareness, weapons of mass

  15. Energy Systems Training Programs and Certifications Survey White Paper

    Energy Technology Data Exchange (ETDEWEB)

    Cox, Daryl [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Nimbalkar, Sachin U. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wenning, Thomas J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Thirumaran, Kiran [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Guo, Wei [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-02-01

    Compressed air system, industrial refrigeration system, chilled water system, pump system, fan system, steam system, process heating system, and combined heat and power system are the major industrial energy systems. By helping enhance knowledge and skills of workforce, training and certification programs on these systems are essential to improve energy efficiency of manufacturing facilities. A literature survey of currently available training and certification programs on these systems was conducted.

  16. A multi-media computer program for training in basic professional counseling skills

    NARCIS (Netherlands)

    Adema, J.; Van der Zee, K.I.

    2003-01-01

    This paper concerns the development of a self-instructional program for training in basic counseling skills. The product was a multimedia computer program, named GEVAT. The training under consideration was based on a traditional training in which students enhance these skills under supervision.

  17. Medical Team Training Improves Team Performance: AOA Critical Issues.

    Science.gov (United States)

    Carpenter, James E; Bagian, James P; Snider, Rebecca G; Jeray, Kyle J

    2017-09-20

    Effective teamwork and communication can decrease medical errors in environments where the culture of safety is enhanced. Health care can benefit from programs that are based on teamwork, as in other high-stress industries (e.g., aviation), with crew resource management programs, simulator use, and utilization of checklists. Medical team training (MTT) with a strong leadership commitment was used at our institution to focus specifically on creating open, yet structured, communication in operating rooms. Training included the 3 phases of the World Health Organization protocol to organize communication and briefings: preoperative verification, preincision briefing, and debriefing at or near the end of the surgical case. This training program led to measured improvements in job satisfaction and compliance with checklist tasks, and identified opportunities to improve training sessions. MTT provides the potential for sustainable change and a positive impact on the environment of the operating room.

  18. Team play in surgical education: a simulation-based study.

    Science.gov (United States)

    Marr, Mollie; Hemmert, Keith; Nguyen, Andrew H; Combs, Ronnie; Annamalai, Alagappan; Miller, George; Pachter, H Leon; Turner, James; Rifkind, Kenneth; Cohen, Steven M

    2012-01-01

    Simulation-based training provides a low-stress learning environment where real-life emergencies can be practiced. Simulation can improve surgical education and patient care in crisis situations through a team approach emphasizing interpersonal and communication skills. This study assessed the effects of simulation-based training in the context of trauma resuscitation in teams of trainees. In a New York State-certified level I trauma center, trauma alerts were assessed by a standardized video review process. Simulation training was provided in various trauma situations followed by a debriefing period. The outcomes measured included the number of healthcare workers involved in the resuscitation, the percentage of healthcare workers in role position, time to intubation, time to intubation from paralysis, time to obtain first imaging study, time to leave trauma bay for computed tomography scan or the operating room, presence of team leader, and presence of spinal stabilization. Thirty cases were video analyzed presimulation and postsimulation training. The two data sets were compared via a 1-sided t test for significance (p role positions increased from 57.8% to 83.6% (p = 0.46). The time to intubation from paralysis decreased from 3.9 to 2.8 minutes (p team leader increased from 64% to 90% (p team interaction and educational competencies. Providing simulation training as a tool for surgical education may enhance patient care. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. 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.

  20. Dyslexia Training Program. What Works Clearinghouse Intervention Report

    Science.gov (United States)

    What Works Clearinghouse, 2010

    2010-01-01

    The "Dyslexia Training Program," developed at the Texas Scottish Rite Hospital for Children, is a Tier III reading intervention program that provides intensive phonics instruction to children with dyslexia, primarily in grades two through five. It is a comprehensive two-year program that bridges the gap for school districts in which a…