Pub Date : 1900-01-01DOI: 10.1102/2051-7726.2022.0008
B. Krishnamoorthy, W. Critchley, Jeni Palima, Rajen Dinesh Shah, S. Kendall, N. Moorjani, Carol Tan, S. Rathinam
{"title":"Educating cardiothoracic health care practitioners during the COVID-19 pandemic: results from an online survey on a series of webinars","authors":"B. Krishnamoorthy, W. Critchley, Jeni Palima, Rajen Dinesh Shah, S. Kendall, N. Moorjani, Carol Tan, S. Rathinam","doi":"10.1102/2051-7726.2022.0008","DOIUrl":"https://doi.org/10.1102/2051-7726.2022.0008","url":null,"abstract":"","PeriodicalId":202461,"journal":{"name":"Journal of Surgical Simulation","volume":"230 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116211349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1016/j.hpb.2019.10.1791
J. Koong, S. Choy, N. Bahuri, P. N. Sitaram, Diana Mohd Shah, H. Omar, A. Kamarulzaman
{"title":"Organ donation innovative strategies for Southeast Asia: ODISSeA","authors":"J. Koong, S. Choy, N. Bahuri, P. N. Sitaram, Diana Mohd Shah, H. Omar, A. Kamarulzaman","doi":"10.1016/j.hpb.2019.10.1791","DOIUrl":"https://doi.org/10.1016/j.hpb.2019.10.1791","url":null,"abstract":"","PeriodicalId":202461,"journal":{"name":"Journal of Surgical Simulation","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116630734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1102/2051-7726.2021.0004
Mathew Lyons, O. Brown, B. Ip
Background and Aim: Laparoscopic box trainers are valuable in the teaching of basic laparoscopic skills. This study aims to define the impact of formal tuition, supervised practice and feedback on the acquisition of basic laparoscopic skills on a box trainer by novice. Methods: All medical undergraduate attendees of a conference were invited to participate. Participants with previous experience on laparoscopic simulators were excluded. Twenty-eight were randomized to the control group (self-directed learning/practice), 23 to the intervention group (formal tuition/supervised practice/feedback). Baseline and post-intervention performance were assessed using the Global Operative Assessment of Laparoscopic Skills (GOALS) score by blinded assessors. Results: Both groups showed an overall increase in GOALS score after exposure to the box trainer: control group, 7.79 (SD, 2.23) pre-intervention versus 8.25 (SD 3.04) postintervention; intervention group: 8.43 (SD 2.13) pre-intervention versus 9.35 (SD 2.42) post-intervention (P=0.52). The intervention group showed a greater overall increase in GOALS score compared with the control group, but this was not statistically significant (control mean improvement, + 0.46 [SD 4.08] versus intervention mean improvement + 0.91 [SD 3.84]; P=0.66). A lower performance in depth perception was reported for the control group (mean, 0.07). Conclusions: Box trainers are effective in assisting novices to acquire basic laparoscopic skills. Expert tuition, supervised practice and feedback appear to have an additional positive effect.
{"title":"Impact of formal tuition, supervised practice and feedback on the acquisition of basic laparoscopic skills by novices using a box trainer","authors":"Mathew Lyons, O. Brown, B. Ip","doi":"10.1102/2051-7726.2021.0004","DOIUrl":"https://doi.org/10.1102/2051-7726.2021.0004","url":null,"abstract":"Background and Aim: Laparoscopic box trainers are valuable in the teaching of basic laparoscopic skills. This study aims to define the impact of formal tuition, supervised practice and feedback on the acquisition of basic laparoscopic skills on a box trainer by novice. Methods: All medical undergraduate attendees of a conference were invited to participate. Participants with previous experience on laparoscopic simulators were excluded. Twenty-eight were randomized to the control group (self-directed learning/practice), 23 to the intervention group (formal tuition/supervised practice/feedback). Baseline and post-intervention performance were assessed using the Global Operative Assessment of Laparoscopic Skills (GOALS) score by blinded assessors. Results: Both groups showed an overall increase in GOALS score after exposure to the box trainer: control group, 7.79 (SD, 2.23) pre-intervention versus 8.25 (SD 3.04) postintervention; intervention group: 8.43 (SD 2.13) pre-intervention versus 9.35 (SD 2.42) post-intervention (P=0.52). The intervention group showed a greater overall increase in GOALS score compared with the control group, but this was not statistically significant (control mean improvement, + 0.46 [SD 4.08] versus intervention mean improvement + 0.91 [SD 3.84]; P=0.66). A lower performance in depth perception was reported for the control group (mean, 0.07). Conclusions: Box trainers are effective in assisting novices to acquire basic laparoscopic skills. Expert tuition, supervised practice and feedback appear to have an additional positive effect.","PeriodicalId":202461,"journal":{"name":"Journal of Surgical Simulation","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129566346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1102/2051-7726.2019.0005
Niall Downey
Human error is inevitable in all walks of life. It generally has little effect, unless you work in a safety-critical industry. Aviation and healthcare are two such industries although they have very different approaches to managing error. They also have very different outcomes regarding mortality/morbidity related to error. This paper discusses how aviation achieves these results and how they could be transferred to healthcare. Aviation has a three-stage approach to managing error. First, we have a “Just Culture” which means we can own up to genuine mistakes without fear of disciplinary action or sanctions as long as we cooperate with investigating how the error occurred. It is not a “No-Blame” culture; we are still expected to take responsibility for our actions. Second, we investigate each event to find why the error occurred. We usually identify a “tripwire” which led to the individual making the error. We assess whether we can re-engineer the system to remove the tripwire and, if possible, add a safety net to reduce the chance of recurrence. Third, we train staff in error management as part of both initial training and recurrent training. Aviation globally is now focussing on introducing evidence-based training to better meet the needs of the crew and make most effective use of expensive training time. These principles are relevant and transferable to healthcare and could potentially be equally successful there. Success, however, relies on a change in culture by both staff and patients. Error needs to be accepted as inevitable in healthcare, as it is in aviation, and that the outcome is determined by how it is managed. We need to focus on “what went wrong” as opposed to “who went wrong” and accept that attributing blame and demanding retribution is not a sustainable approach.
{"title":"Ever made a mistake? The role of aviation-style error management in healthcare","authors":"Niall Downey","doi":"10.1102/2051-7726.2019.0005","DOIUrl":"https://doi.org/10.1102/2051-7726.2019.0005","url":null,"abstract":"Human error is inevitable in all walks of life. It generally has little effect, unless you work in a safety-critical industry. Aviation and healthcare are two such industries although they have very different approaches to managing error. They also have very different outcomes regarding mortality/morbidity related to error. This paper discusses how aviation achieves these results and how they could be transferred to healthcare. Aviation has a three-stage approach to managing error. First, we have a “Just Culture” which means we can own up to genuine mistakes without fear of disciplinary action or sanctions as long as we cooperate with investigating how the error occurred. It is not a “No-Blame” culture; we are still expected to take responsibility for our actions. Second, we investigate each event to find why the error occurred. We usually identify a “tripwire” which led to the individual making the error. We assess whether we can re-engineer the system to remove the tripwire and, if possible, add a safety net to reduce the chance of recurrence. Third, we train staff in error management as part of both initial training and recurrent training. Aviation globally is now focussing on introducing evidence-based training to better meet the needs of the crew and make most effective use of expensive training time. These principles are relevant and transferable to healthcare and could potentially be equally successful there. Success, however, relies on a change in culture by both staff and patients. Error needs to be accepted as inevitable in healthcare, as it is in aviation, and that the outcome is determined by how it is managed. We need to focus on “what went wrong” as opposed to “who went wrong” and accept that attributing blame and demanding retribution is not a sustainable approach.","PeriodicalId":202461,"journal":{"name":"Journal of Surgical Simulation","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123479415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1102/2051-7726.2021.a018
{"title":"Satisfaction with video-conferencing as a tool for postgraduate surgical teaching in the time of social distancing","authors":"","doi":"10.1102/2051-7726.2021.a018","DOIUrl":"https://doi.org/10.1102/2051-7726.2021.a018","url":null,"abstract":"","PeriodicalId":202461,"journal":{"name":"Journal of Surgical Simulation","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133244618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1102/2051-7726.2021.a023
{"title":"Chest imaging and RT-PCR testing for acute abdominal pain during the COVID-19 pandemic","authors":"","doi":"10.1102/2051-7726.2021.a023","DOIUrl":"https://doi.org/10.1102/2051-7726.2021.a023","url":null,"abstract":"","PeriodicalId":202461,"journal":{"name":"Journal of Surgical Simulation","volume":"268 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116492342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1102/2051-7726.2019.0001
A. Musbahi, J. Henton
Introduction: Surgical training has undergone many changes in the last few decades from the apprenticeship model of the past and a focus currently on shift patterns and working time directives. These have placed greater stresses on the current surgical trainees to obtain training opportunities, thus increasing the role for simulation activities and models. There is a need for reproducible, low cost and realistic training models for all surgical subspecialties. These allow the training exercise to be undertaken at any time, with supervision, and in a safe environment without compromise to patient care. As a training model for tendon repair, we created a simulated tendon that we believe is an excellent alternative to cadaveric, porcine or other materials such as liquorice. Methods: Experienced trainees and consultants with exposure and experience in performing human tendon repair were asked to perform a simulated repair on each of three models: silicone bathroom sealant, porcine tendon and liquorice. Each model tendon was secured to a wooden board and cut at its midpoint. The models were 5 mm in diameter and between 5 and 10 cm long. Participants performed a modified Kessler repair using standard surgical instruments and a 3-0 monofilament suture, and rated each model using a five-point Likert scale to assess suture gliding, likeness to human tendon, tendon handling and usefulness for training. Results: The porcine tendon was considered the most realistic (90.5%); however, the silicone model was a close second (86.5%). Silicone compared well for handling (4.4/5) and was considered superior to liquorice on all points. Conclusion: Silicone sealant as a model tendon is cheap, reproducible and a satisfactory alternative to other models of tendon simulation repair, and can be used to provide training opportunities.
{"title":"Tendon repair simulation: a comparison of training models","authors":"A. Musbahi, J. Henton","doi":"10.1102/2051-7726.2019.0001","DOIUrl":"https://doi.org/10.1102/2051-7726.2019.0001","url":null,"abstract":"Introduction: Surgical training has undergone many changes in the last few decades from the apprenticeship model of the past and a focus currently on shift patterns and working time directives. These have placed greater stresses on the current surgical trainees to obtain training opportunities, thus increasing the role for simulation activities and models. There is a need for reproducible, low cost and realistic training models for all surgical subspecialties. These allow the training exercise to be undertaken at any time, with supervision, and in a safe environment without compromise to patient care. As a training model for tendon repair, we created a simulated tendon that we believe is an excellent alternative to cadaveric, porcine or other materials such as liquorice. Methods: Experienced trainees and consultants with exposure and experience in performing human tendon repair were asked to perform a simulated repair on each of three models: silicone bathroom sealant, porcine tendon and liquorice. Each model tendon was secured to a wooden board and cut at its midpoint. The models were 5 mm in diameter and between 5 and 10 cm long. Participants performed a modified Kessler repair using standard surgical instruments and a 3-0 monofilament suture, and rated each model using a five-point Likert scale to assess suture gliding, likeness to human tendon, tendon handling and usefulness for training. Results: The porcine tendon was considered the most realistic (90.5%); however, the silicone model was a close second (86.5%). Silicone compared well for handling (4.4/5) and was considered superior to liquorice on all points. Conclusion: Silicone sealant as a model tendon is cheap, reproducible and a satisfactory alternative to other models of tendon simulation repair, and can be used to provide training opportunities.","PeriodicalId":202461,"journal":{"name":"Journal of Surgical Simulation","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129404671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1102/2051-7726.2021.0012
Cara King, A. Kim, N. Donnellan, V. Lerner
{"title":"Major vascular injury during minimally invasive gynecologic surgery: simulation-based approach to teaching surgical crisis management skills","authors":"Cara King, A. Kim, N. Donnellan, V. Lerner","doi":"10.1102/2051-7726.2021.0012","DOIUrl":"https://doi.org/10.1102/2051-7726.2021.0012","url":null,"abstract":"","PeriodicalId":202461,"journal":{"name":"Journal of Surgical Simulation","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129069614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1102/2051-7726.2019.0006
Y. Sardiwalla, Nadim Joukhadar, David T. Tang
Introduction: Surgical teaching in the operating room represents a unique and distinct aspect of medical education. Traditionally, an apprenticeship model of learning and feedback has been used. Recent changes in residency education have demanded a reevaluation of this model, resulting in the pursuit of improving educational feedback in the operating room through structured feedback. The Ottawa Surgical Competency Operating Room Evaluation (O-SCORE) evaluates surgical skills and was recently introduced to the Plastic Surgery Training Program in addition to the traditional InTraining Evaluation Report (ITER). Methods: Plastic surgery residents (postgraduate years 2–5, N = 9) who were exposed to the transition between using ITER and O-SCORE evaluations were recruited. A grounded theory approach was used to analyze a semi-structured focus group with the residents. In addition, a 5-minute survey contrasting ITER and O-SCORE methods was distributed. Results: Residents suggested the O-SCORE has led to more opportune feedback, more comprehensive discussion of surgical procedures, and improved progress tracking compared with traditional methods. Although there is a role for reactionary feedback, residents unanimously agreed that the OSCORE heralded an improvement in their learning. Conclusion: The introduction of the O-SCORE to the Plastic Surgery Program has complemented traditional feedback. Even though the O-SCORE adds to the evaluation burden, it may have an important role in the assessment structure of surgical residency training programs.
{"title":"A literature review of educational feedback in the operating room: plastic surgery residents’ perception of feedback from the O-SCORE","authors":"Y. Sardiwalla, Nadim Joukhadar, David T. Tang","doi":"10.1102/2051-7726.2019.0006","DOIUrl":"https://doi.org/10.1102/2051-7726.2019.0006","url":null,"abstract":"Introduction: Surgical teaching in the operating room represents a unique and distinct aspect of medical education. Traditionally, an apprenticeship model of learning and feedback has been used. Recent changes in residency education have demanded a reevaluation of this model, resulting in the pursuit of improving educational feedback in the operating room through structured feedback. The Ottawa Surgical Competency Operating Room Evaluation (O-SCORE) evaluates surgical skills and was recently introduced to the Plastic Surgery Training Program in addition to the traditional InTraining Evaluation Report (ITER). Methods: Plastic surgery residents (postgraduate years 2–5, N = 9) who were exposed to the transition between using ITER and O-SCORE evaluations were recruited. A grounded theory approach was used to analyze a semi-structured focus group with the residents. In addition, a 5-minute survey contrasting ITER and O-SCORE methods was distributed. Results: Residents suggested the O-SCORE has led to more opportune feedback, more comprehensive discussion of surgical procedures, and improved progress tracking compared with traditional methods. Although there is a role for reactionary feedback, residents unanimously agreed that the OSCORE heralded an improvement in their learning. Conclusion: The introduction of the O-SCORE to the Plastic Surgery Program has complemented traditional feedback. Even though the O-SCORE adds to the evaluation burden, it may have an important role in the assessment structure of surgical residency training programs.","PeriodicalId":202461,"journal":{"name":"Journal of Surgical Simulation","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127914007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1102/2051-7726.2021.0001
A. Feeley, I. Feeley, K. Merghani, E. Sheehan
Background: Simulated surgical learning is an evolving training modality for surgical trainees. Its use in transferring simulation-based skills to the operating room is an integral aspect of its use as a pedagogical tool for surgical trainees in an era of reduced working hours and fewer intra-operative opportunities. These systems may allow trainees to upskill in simulated scenarios leading to improved skillsets and patient safety. The aim of this review was to evaluate if acquisition of surgical skills developed in simulated procedures results in improved intra-operative performance and whether this can be integrated into current surgical curricula. Methods: A systematic search was conducted using PubMed, OVID Medline and CINAHL. Articles included were based on specific inclusion and exclusion criteria. Critical appraisal tools were used to assess each article’s authenticity, applicability and quality of results. Results: Twenty-six studies were reviewed in full and included in this review according to PRISMA guidelines. Thematic analysis yielded four main themes: predictive validity, surgical curriculum, timing of training, clinical outcomes. All studies demonstrated validity. Conclusion: A heterogeneous group of studies demonstrated mixed findings in the predictive validity of virtual reality learning. However, adaptation into surgical curricula in conjunction with other forms of surgical education yielded positive results, with predictive validity demonstrated in surgical trainees. Further research is required to elicit optimal training stages and use of simulation in development of non-technical skills.
{"title":"Use of virtual reality simulation in surgical training: a systematic review on predictive validity and current use in surgical curricula","authors":"A. Feeley, I. Feeley, K. Merghani, E. Sheehan","doi":"10.1102/2051-7726.2021.0001","DOIUrl":"https://doi.org/10.1102/2051-7726.2021.0001","url":null,"abstract":"Background: Simulated surgical learning is an evolving training modality for surgical trainees. Its use in transferring simulation-based skills to the operating room is an integral aspect of its use as a pedagogical tool for surgical trainees in an era of reduced working hours and fewer intra-operative opportunities. These systems may allow trainees to upskill in simulated scenarios leading to improved skillsets and patient safety. The aim of this review was to evaluate if acquisition of surgical skills developed in simulated procedures results in improved intra-operative performance and whether this can be integrated into current surgical curricula. Methods: A systematic search was conducted using PubMed, OVID Medline and CINAHL. Articles included were based on specific inclusion and exclusion criteria. Critical appraisal tools were used to assess each article’s authenticity, applicability and quality of results. Results: Twenty-six studies were reviewed in full and included in this review according to PRISMA guidelines. Thematic analysis yielded four main themes: predictive validity, surgical curriculum, timing of training, clinical outcomes. All studies demonstrated validity. Conclusion: A heterogeneous group of studies demonstrated mixed findings in the predictive validity of virtual reality learning. However, adaptation into surgical curricula in conjunction with other forms of surgical education yielded positive results, with predictive validity demonstrated in surgical trainees. Further research is required to elicit optimal training stages and use of simulation in development of non-technical skills.","PeriodicalId":202461,"journal":{"name":"Journal of Surgical Simulation","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134341698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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