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A new porcine training phantom for percutaneous nephrostomy insertion 一种用于经皮肾造口术的猪训练假体
Pub Date : 1900-01-01 DOI: 10.1102/2051-7726.2022.0014
J.J. Pat, Matthew Tam
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引用次数: 0
How can virtual reality create a better way to learn basic life support? 虚拟现实如何创造一种更好的学习基本生命支持的方式?
Pub Date : 1900-01-01 DOI: 10.1102/2051-7726.2019.a004
Anna Stoilova
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引用次数: 0
A vascularized emergency trauma amputation simulator for surgical skills training 用于外科技能训练的血管化急诊创伤截肢模拟器
Pub Date : 1900-01-01 DOI: 10.1102/2051-7726.2021.0005
A. Chandra, Lauren Harvey, Sahand Fardi, Eric Krohn, Shumaila Anwer, J. Harmon
Background: We describe the development of a low-cost lower-extremity amputation model enhanced with simulated pulsatile vasculature (SPV). The vascularized emergency trauma amputation simulator (VETAS) permits students to practice clinical decision-making, prepping and draping, hemostatic knot-tying, and lower-extremity amputation. SPV was achieved using a microcontroller, regulating the flow of artificial blood through a bypass flow system, preventing excessive pressure when the SPV is clamped. The SPV system replicates a pulse of 75 beats/min, a pressure of 120/80 mmHg, and a flow rate of 350 mL/min. We assessed if the model and simulation scenario accomplished our design goals of cost-effective, multidimensional education, with efficient turnover between learners. Methods: A low-cost VETAS was engineered to simulate the tibia and tibial artery using SPV. A simulation scenario was prepared for medical students’ training. A preand post-training survey was completed by 53 attendees to evaluate the experience. Survey responses were ranked using a Likert scale and analyzed using a Wilcoxon signed-rank test. Results: The VETAS was constructed with inexpensive, readily available materials. The technology allows for efficient, reproducible training. Post-training survey analysis demonstrated statistically significant increases in familiarity with creating a sterile surgical field and with proper instrument handling (P50.001). An increased sense of confidence regarding lowerextremity surgical anatomy was also confirmed (P50.014). Conclusion: The VETAS model successfully introduced medical students to the principles of emergency trauma surgery. This novel technology created a cost-effective platform for efficient and effective skills training.
背景:我们描述了一个低成本的下肢截肢模型的发展与模拟搏动血管(SPV)增强。血管化紧急创伤截肢模拟器(VETAS)允许学生练习临床决策,准备和悬垂,止血打结和下肢截肢。SPV是通过微控制器实现的,通过旁路血流系统调节人工血液的流量,防止SPV夹紧时压力过大。SPV系统可以复制75次/分钟的脉冲,120/80 mmHg的压力,350 mL/分钟的流量。我们评估了模型和模拟场景是否实现了我们的设计目标,即具有成本效益的多维教育,以及学习者之间的有效周转。方法:采用SPV技术制备低成本的VETAS,模拟胫骨和胫骨动脉。为医学生的训练准备了一个模拟场景。53名参与者完成了培训前和培训后的调查,以评估他们的体验。调查结果使用李克特量表进行排名,并使用Wilcoxon符号秩检验进行分析。结果:采用廉价、易得的材料构建VETAS。这项技术允许进行有效的、可重复的训练。培训后调查分析显示,对无菌手术环境的熟悉程度和正确操作器械的熟悉程度有统计学意义上的显著提高(P50.001)。对下肢手术解剖的信心也有所增加(P50.014)。结论:VETAS模型成功地向医学生介绍了急诊创伤外科的原理。这项新技术为高效和有效的技能培训创造了一个具有成本效益的平台。
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引用次数: 0
YouTube as an educational tool: the launch of a simulated surgical procedures channel YouTube作为教育工具:推出模拟外科手术频道
Pub Date : 1900-01-01 DOI: 10.1102/2051-7726.2019.0004
M. Yiasemidou, A. Kordowicz, Jonathan de Siqueiraa, M. Gough
Background: Electronic audiovisual materials have the potential to revolutionize surgical training. The widespread use of social media has made this medium more accessible to surgical trainees. The success of online resources is measured with quantitative measures such as viewer numbers, which do not necessarily reflect the quality of the didactic tools provided. The aim of this study is to assess face and content validity of YouTube as a free multimedia channel for surgical education. Methods: In 2014, Yorkshire and the Humber School of Surgery launched a YouTube educational channel aimed at providing additional multimedia training experience to core surgical trainees and anyone else who wishes to use it globally. At the time this study was conducted, the channel included 14 videos of simulated procedures and each video was linked to an online survey. Results: At the time this study was conducted, 53 viewers had answered an online survey, which was voluntary. Forty-three of the 53 responders found the uploaded videos relevant to their educational needs and 47 assessed the quality of the videos as good. The length and commentary of the videos received praise. Interestingly, the responders considered e-learning resources to be as vital as courses and books. The viewers would like to see more real procedures in future e-learning outlets. Conclusion: The YouTube channel showed good face and content validity, and viewers demonstrated good acceptance of online didactic videos. The authors suggest that the quality of online resources should be assessed with similar tools, as viewership may not necessarily reflect the value of the resources.
背景:电子视听材料具有革新外科训练的潜力。社交媒体的广泛使用使得外科实习生更容易接触到这种媒体。在线资源的成功是通过诸如观看人数之类的定量指标来衡量的,这并不一定反映所提供教学工具的质量。本研究的目的是评估YouTube作为外科教育免费多媒体频道的外观和内容有效性。方法:2014年,约克郡和亨伯外科学院推出了一个YouTube教育频道,旨在为核心外科学员和任何希望在全球范围内使用它的人提供额外的多媒体培训体验。在进行这项研究时,该频道包括14个模拟过程的视频,每个视频都链接到一个在线调查。结果:在这项研究进行的时候,53名观众回答了一项在线调查,这是自愿的。53名应答者中有43人认为上传的视频与他们的教育需求相关,47人认为视频质量良好。视频的长度和评论得到了好评。有趣的是,受访者认为电子学习资源与课程和书籍一样重要。观众希望在未来的电子学习平台上看到更多真实的流程。结论:YouTube频道表现出良好的面貌和内容效度,观众对在线教学视频的接受度较高。作者建议,在线资源的质量应该用类似的工具来评估,因为浏览量不一定反映资源的价值。
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引用次数: 0
Single-group analysis of simulation training improves the ability of anesthesiologist assistant students to use TeamSTEPPS during crisis management scenarios 模拟训练的单组分析提高了麻醉师助理学生在危机管理场景中使用TeamSTEPPS的能力
Pub Date : 1900-01-01 DOI: 10.1102/2051-7726.2019.0007
Trine Vik, F. Puskas, Erik Nelson
Background: Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) was developed to increase patient safety through improved health care teamwork skills. The purpose of this investigation was to determine whether the teamwork skills of anesthesiologist assistant (AA) students improve after training with simulated crisis management scenarios. Methods: This is a single-group pre-intervention and post-intervention study that included 12 students and four evaluators during crisis management simulations. Student self-assessment surveys and preceptor evaluation forms were administered before and after the intervention. The self-assessment survey evaluated their knowledge of and clinical utility of TeamSTEPPS strategies, and how well they applied specific TeamSTEPPS skills. The preceptors evaluated how the students performed the TeamSTEPPS skills along with their knowledge of principles and team structure. The survey and evaluation questions used a 5-point Likert scale. The intervention consisted of teaching the students the TeamSTEPPS Essentials course and giving feedback between the two crisis management scenarios. Results: Student self-evaluation scores on TeamSTEPPS knowledge (1.25–4.08, P 5 0.001), utility (3.75–4.75, P = 0.03), leadership (2.08–3.17, P = 0.02), and mutual support (2.42–3.25, P = 0.03) showed improvement. Differences in student self-evaluation scores on communication (3.25–3.50, P = 0.55) were non-significant. Preceptor evaluation for TeamSTEPPS knowledge (1.52–3.85, P 5 0.001), team structure (1.96–4.08, P 5 0.001), leadership (2.33–3.52, P = 0.006), communication (2.54–3.61, P = 0.023), mutual support (2.08–3.27, P = 0.005), and situational awareness (2.40– 3.69, P = 0.002) all showed significant improvement. Conclusion: This innovative curriculum helps AA students to learn the principles of TeamSTEPPS and improves their performance during simulated crisis management scenarios.
背景:提高绩效和患者安全的团队战略和工具(TeamSTEPPS)是为了通过提高医疗团队合作技能来提高患者安全而开发的。本研究旨在探讨麻醉医师助理(AA)学生在接受模拟危机管理情景训练后,其团队合作能力是否有所提高。方法:这是一项单组干预前和干预后研究,包括12名学生和4名危机管理模拟评估员。在干预前后分别进行学生自我评估调查和导师评估表。自我评估调查评估了他们对TeamSTEPPS策略的知识和临床效用,以及他们如何应用特定的TeamSTEPPS技能。导师们评估了学生们如何运用TeamSTEPPS技能,以及他们对原则和团队结构的了解。调查和评估问题采用5分李克特量表。干预包括教授学生TeamSTEPPS要点课程,并在两种危机管理方案之间给出反馈。结果:学生在TeamSTEPPS知识(1.25 ~ 4.08,P = 5 0.001)、效用(3.75 ~ 4.75,P = 0.03)、领导能力(2.08 ~ 3.17,P = 0.02)、相互支持(2.42 ~ 3.25,P = 0.03)方面的自我评价得分均有提高。学生沟通自我评价得分差异无统计学意义(3.25 ~ 3.50,P = 0.55)。训导对TeamSTEPPS知识(1.52 ~ 3.85,P = 5 0.001)、团队结构(1.96 ~ 4.08,P = 5 0.001)、领导力(2.33 ~ 3.52,P = 0.006)、沟通(2.54 ~ 3.61,P = 0.023)、相互支持(2.08 ~ 3.27,P = 0.005)、态势感知(2.40 ~ 3.69,P = 0.002)的评价均有显著提高。结论:该创新课程帮助AA学生学习TeamSTEPPS的原则,并提高他们在模拟危机管理场景中的表现。
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引用次数: 0
Audit of immediate instillation of intravesical chemotherapy (mitomycin-C) following transurethral resection for bladder tumour 经尿道膀胱肿瘤切除术后即刻膀胱内灌注化疗(丝裂霉素- c)的审计
Pub Date : 1900-01-01 DOI: 10.1102/2051-7726.2021.a004
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引用次数: 0
Bowel anastomosis training simulator: design and pilot testing 肠吻合训练模拟器:设计与试验
Pub Date : 1900-01-01 DOI: 10.1102/2051-7726.2022.0009
Britney Niemann, Conley Stout, Justin R. Chambers, S. Wen, N. Szoka
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引用次数: 0
The developing role of simulation within surgical training and the need for equitable access: a narrative review 模拟在外科训练中的发展作用和公平获取的需要:叙述回顾
Pub Date : 1900-01-01 DOI: 10.1102/2051-7726.2022.0001
C. Taylor, A. Corriero
Background: In recent years, surgical training has undergone considerable change and COVID-19 has accelerated the rate at which training methods have needed to be updated. Education of surgical trainees is now transitioning from that of a clinical setting to that of a simulated skills laboratory. This article aims to outline the importance of ensuring equitable access to high-fidelity surgical training equipment and to bring to attention the potential consequences of nonstandardized surgical simulation exposure. Methods: Data collection was performed using the PubMed, Ovid MEDLINE and Embase bibliographical databases with a predefined search strategy between 11 February 2021 and 1 June 2021. All articles considering surgical education via simulation technologies were considered. Results: Twentyeight studies were deemed eligible for inclusion in a qualitative synthesis. Despite the increasing popularity of simulation, simulation-guided learning has yet to become fully integrated within all curricula, and the use of these technologies is yet to be adequately evaluated in a post-pandemic context. Therefore, there is a need to educate and inform medical students and surgical trainees, who will all be required to learn from and be assessed on simulated clinical technologies. Conclusions: Surgical training methods must be consistently updated so that they reflect the transitioning cultural, social-economic, and political expectations and restraints on surgical curricula. Continual development of simulation facilities is required to ensure sustainable integration within surgical training. Equitable access for all trainees must be a future point of focus if surgical training is to continue at its current level.
背景:近年来,外科培训发生了相当大的变化,COVID-19加快了培训方法更新的速度。外科培训生的教育现在正从临床环境过渡到模拟技能实验室环境。本文旨在概述确保公平获得高保真外科训练设备的重要性,并提请注意非标准化手术模拟暴露的潜在后果。方法:在2021年2月11日至2021年6月1日期间,使用PubMed、Ovid MEDLINE和Embase书目数据库进行数据收集,并采用预定义的搜索策略。所有涉及通过模拟技术进行外科教育的文章都被纳入考虑范围。结果:28项研究被认为有资格纳入定性综合。尽管模拟越来越受欢迎,但模拟指导的学习尚未完全纳入所有课程,而且在大流行后的背景下,这些技术的使用尚未得到充分评估。因此,有必要对医学生和外科培训生进行教育和宣传,他们都将被要求学习和评估模拟临床技术。结论:外科培训方法必须不断更新,以反映正在转变的文化、社会经济和政治期望以及对外科课程的限制。需要不断发展模拟设施,以确保外科培训的可持续整合。如果外科培训要在目前的水平上继续下去,所有受训者的公平机会必须成为未来的重点。
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引用次数: 0
Effects of transcranial direct current stimulation on surgical skills acquisition: a systematic review 经颅直流电刺激对外科技能习得的影响:系统综述
Pub Date : 1900-01-01 DOI: 10.1102/2051-7726.2021.0007
A. Naiem, F. Reyna-Sepúlveda, Ibtisam Mahmoud, M. Lukaszewski, H. Gill, Alexander Thiel, E. Girsowicz
Background: Surgical training is opportunity based, and multiple factors including exposure time, case volume and simulation training contribute to achieving competencies. We aimed to evaluate the effects of transcranial direct current stimulation (TDCS) as an adjunct to attain surgical skills faster. Methods: A registered systematic review (PROSPERO number CRD42020211985) of randomized trials (RCTs) on Biosis, Cochrane Central, EMBASE, MEDLINE, PsycINFO databases was carried out. Studies included compared active TDCS to sham stimulation in a surgical task involving trainees. Outcomes were grouped into four domains to overcome the heterogeneity of study outcomes: speed of skills acquisition; proficiency, i.e. ability to achieve a pre-determined score/level of proficiency; accuracy and error reduction; and composite outcomes involving more than one domain. Results: Four RCTs were identified involving 143 participants in total (61 sham, 82 TDCS). All studies utilized simulation training: three in laparoscopic training (peg transfer and pattern cutting), and one in neurosurgery training (tumour resection exercise). The mean age of the participants was 24.5 1.5 years, 58% (n=83) were female and 92% (n=131) were right hand dominant. Use of TDCS was associated with improved speed of skills acquisition, proficiency, accuracy and a less steep learning curve. This performance advantage was sustained for at least 6 weeks. Conclusions: TDCS may be a useful, safe adjunct for surgical simulation training. It is associated with improved skills acquisition in both laparoscopic and neurosurgical training tasks. Further research is needed to evaluate its use in other surgical specialties.
背景:外科训练是基于机会的,包括暴露时间、病例量和模拟训练在内的多种因素有助于获得能力。我们的目的是评估经颅直流电刺激(TDCS)作为一种辅助手段的效果,以更快地获得手术技能。方法:对Biosis、Cochrane Central、EMBASE、MEDLINE、PsycINFO数据库的随机试验(rct)进行注册系统评价(PROSPERO号CRD42020211985)。研究包括在涉及受训者的手术任务中比较活跃的TDCS和假刺激。结果分为四个领域,以克服研究结果的异质性:技能习得速度;熟练程度,即达到预定分数/熟练程度的能力;降低精度和误差;复合结果涉及不止一个域。结果:四项随机对照试验共涉及143名参与者(61名假手术,82名TDCS)。所有的研究都使用了模拟训练:三个在腹腔镜训练(peg转移和模式切割),一个在神经外科训练(肿瘤切除练习)。参与者的平均年龄为24.5 - 1.5岁,58% (n=83)为女性,92% (n=131)为右手优势者。TDCS的使用与提高技能习得速度、熟练程度、准确性和较平缓的学习曲线有关。这种性能优势持续了至少6周。结论:TDCS是一种有效、安全的外科模拟训练辅助手段。它与腹腔镜和神经外科训练任务中技能获得的改善有关。需要进一步的研究来评估其在其他外科专业的应用。
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引用次数: 0
Surgical on-call simulation: an effective teaching method for medical students 外科随叫随到模拟:一种有效的医学生教学方法
Pub Date : 1900-01-01 DOI: 10.1102/2051-7726.2021.a011
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引用次数: 0
期刊
Journal of Surgical Simulation
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