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Ortega MAC, Marchese VG, Zarro MJ, Film RJ, Shipper AG, Felter C. Digital and blended curriculum delivery in health professions education: an umbrella review with implications for Doctor of Physical Therapy education programs. PHYSICAL THERAPY REVIEWS 2021. [DOI: 10.1080/10833196.2021.2000286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Megan A. Connelly Ortega
- Department of Physical Therapy and Rehabilitation Science, University of Maryland, Baltimore, MD, USA
| | - Victoria G. Marchese
- Department of Physical Therapy and Rehabilitation Science, University of Maryland, Baltimore, MD, USA
| | - Michael J. Zarro
- Department of Physical Therapy and Rehabilitation Science, University of Maryland, Baltimore, MD, USA
- Department of Orthopaedics, University of Maryland, Baltimore, MD, USA
| | - Roy J. Film
- Department of Physical Therapy and Rehabilitation Science, University of Maryland, Baltimore, MD, USA
- Department of Orthopaedics, University of Maryland, Baltimore, MD, USA
| | - Andrea G. Shipper
- Health Sciences and Human Services Library, University of Maryland, Baltimore, MD, USA
| | - Cara Felter
- Department of Physical Therapy and Rehabilitation Science, University of Maryland, Baltimore, MD, USA
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Chan E, Botelho MG, Wong GTC. A flipped classroom, same-level peer-assisted learning approach to clinical skill teaching for medical students. PLoS One 2021; 16:e0258926. [PMID: 34679098 PMCID: PMC8535182 DOI: 10.1371/journal.pone.0258926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 10/11/2021] [Indexed: 11/30/2022] Open
Abstract
Background Clinical procedural skills are vital components of medical education. Increased student intake and limited capacity of medical schools necessitate more efficient ways to deliver clinical skill teaching. This study employed a flipped classroom, peer-assisted learning approach to deliver clinical skill teaching. It aimed to determine the influence of pre-class demonstration video watching and in-class student-student interactions on clinical skill acquisition. Methods In 2017, a cohort of 205 medical students in their penultimate year of undergraduate medical study were recruited, and they learned bag mask ventilation and intravenous cannulation during this study. The participants watched a demonstration video before class, and then underwent self-directed practice as triads. Afterwards, each participant video-recorded their skill performance and completed post-class questionnaires. The videos were evaluated by two blinded assessors. Results A hundred and thirty-one participants (63.9%) completed the questionnaire. For bag mask ventilation, participants who claimed to have watched the corresponding demonstration video before class achieved higher performance scores (those who watched before class: 7.8 ± 1.0; those who did not: 6.3 ± 1.7; p < 0.01). For intravenous cannulation, while there is no significant difference in performance scores (those who watched before class: 14.3 ± 1.3; those who did not: 14.1 ± 1.4; p = 0.295), those who watched the video before class received less interventions from their peers during triad practice (those who watched before class: 2.9 ± 1.8; those who did not: 4.3 ± 2.9; p < 0.05). The questionnaire results showed that most participants preferred the new approach of clinical skill teaching and perceived it to be useful for skill acquisition. Conclusion The flipped classroom, same-level peer-assisted learning model is potentially an effective way to address the current challenges and improve the efficiency of clinical procedural skill teaching in medical schools.
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Affiliation(s)
- Enoch Chan
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Michael George Botelho
- Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Gordon Tin Chun Wong
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- Department of Anaesthesiology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- * E-mail:
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Vázquez Gómez M, Galipienso Eri M, Hernández Martínez A. Has 2020 been a lost year in orthopedic surgery and trauma training? Residents' perceptions. Rev Esp Cir Ortop Traumatol (Engl Ed) 2021; 66:397-402. [PMID: 34419383 PMCID: PMC8373591 DOI: 10.1016/j.recot.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/13/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic has affected specialized healthcare training at all levels. Surgical learning has been severely affected, and the impact on orthopedic surgery residency training has so far not been assessed. MATERIAL AND METHODS An online survey of 17 questions was sent via web link to orthopedic surgery residents throughout Spain between February 10, 2021 and February 28, 2021. The effects of the COVID-19 pandemic on the care and training activities of residents were analyzed. RESULTS A total of 307 orthopedic surgery residents from all over Spain responded to the online survey. A total of 77.2% of the respondents had to suspend their rotations. Of these, 67.5% would like to resume the rotations they missed during the pandemic. A total of 69.7% of scheduled surgeries were suspended. Surgical activity was completely stopped for an average of 8 weeks. 66.8% of the residents consider that their surgical training has been affected and this will have repercussions on their future work. 49.5% considered the online training offered to be insufficient. Of the total number of respondents, 52.1% considered that the impact of the pandemic situation on their training situation was bad or very bad. CONCLUSIONS The data collection shows a negative impact on both theoretical and clinical training. This study highlights the need to continue offering quality training by maximizing learning opportunities.
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Gasteratos K, Paladino JR, Murray WB, Goverman J. Video-Assisted Simulation Training in Burn Management: A Comparative Cohort Study on the Assessment of Technical and Non-technical Competencies. Injury 2021; 52:2154-2159. [PMID: 33773802 DOI: 10.1016/j.injury.2021.03.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/13/2021] [Accepted: 03/14/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Written material remains one of the most common methods of education, however the current generation of learners may benefit from additional different media. In our study, we aim to quantify the effects of an innovative video instruction on subsequent resident performance in a burn patient simulation. METHODS Following IRB approval, 60 Plastic Surgery residents were randomly assigned to two groups. The control group ("non-video" group) (n = 30) was given only written material as preparation. The experimental group ("video" group) (n = 30) was provided access to video training materials in addition to the written material on technical and non-technical skills. Their videotaped performances on simulation were evaluated by a blinded surgical faculty member. The comparison of variables between the two groups was performed using a Mann-Whitney test for non-normal distributions of quantitative variables, and Fisher's Exact Probability test for qualitative data. Statistical significance was set at p < 0.05. RESULTS Compared to the non-video group, the video group achieved significantly higher scores in the technical skills of assessment of breathing (p = 0.015), disability (p = 0.023), and exposure (p = 0.005) and in the non-technical skills of decision-making (p = 0.035). CONCLUSIONS In residents participating in burn patient simulations, video training in advance of the simulation significantly improved their assessments of breathing, disability, and exposure as well as decision-making. Our video is a valuable tool to enhance trainees' technical and non-technical competencies in managing burn patient simulations.
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Affiliation(s)
- Konstantinos Gasteratos
- Department of Plastic and Reconstructive Surgery, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Joseph Robert Paladino
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, United States
| | - W Bosseau Murray
- Anesthesiology, Pennsylvania State University College of Medicine at Milton S. Hershey Medical Center, Hershey, PA, United States
| | - Jeremy Goverman
- Massachusetts General Hospital, Burns Center, Harvard Medical School, Boston, MA, United States.
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Barmettler G, Adnan S, Malcolm TSN, Terhune K, Joshi ART. Power of the collective: A review of multimodal internet-based surgical education resources in the 21st century. J Surg Oncol 2021; 124:174-180. [PMID: 34245581 DOI: 10.1002/jso.26482] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 11/11/2022]
Abstract
Electronic resources have changed surgical education in the 21st century. Resources spanning from digital textbooks to multiple choice question banks, online society meetings, and social media can facilitate surgical education. The COVID pandemic drastically changed the paradigm for education. The ramifications of Zoom lectures and online surgical society meetings will last into the future. Educators and learners can be empowered by the many available electronic resources to enhance surgical training and education.
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Affiliation(s)
- Gabi Barmettler
- Department of Surgery, Einstein Healthcare Network, Jefferson Medical College, Philadelphia, Pennsylvania, USA
| | - Sakib Adnan
- Department of Surgery, Einstein Healthcare Network, Jefferson Medical College, Philadelphia, Pennsylvania, USA
| | - Threshia S N Malcolm
- Department of Surgery, Einstein Healthcare Network, Jefferson Medical College, Philadelphia, Pennsylvania, USA
| | - Kyla Terhune
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Amit R T Joshi
- Department of Surgery, Einstein Healthcare Network, Jefferson Medical College, Philadelphia, Pennsylvania, USA
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Kaulfuss JC, Kluth LA, Marks P, Grange P, Fisch M, Chun FKH, Meyer CP. Long-Term Effects of Mental Training on Manual and Cognitive Skills in Surgical Education - A Prospective Study. JOURNAL OF SURGICAL EDUCATION 2021; 78:1216-1226. [PMID: 33257297 DOI: 10.1016/j.jsurg.2020.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/24/2020] [Accepted: 11/11/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Limited training opportunities and expanding requirements are challenging surgical education, calling for alternative training methods like simulation or mental training. The aim of this study is to evaluate short- and long-term effects of a structured mental training on surgical performance. DESIGN Medical students without laparoscopic experience were randomly assigned to 3 groups: (1) control (2) video training, and (3) video plus mental training performing 2 E-BLUS (European Training in Basic Laparoscopic Urological Skills) exercises, "peg transfer" (PT) and "cutting a circle" (CC). Group 3 performed a structured mental training course (identification of procedural key steps, relaxation, mental vocalization, and imaging). Longitudinal assessment including binominal checklists, global rating scales (GRS), procedural times, and Test of Performance Strategies (TOPS) were performed at baseline, day 2, 14, and after 16 months. Statistical analysis included ANOVA and general linear models with repeated measures. SETTING The study was conducted in "Olympus Training and Education Center Hamburg West" and "Endo Club Academy" at the University Medical Center Hamburg-Eppendorf. PARTICIPANTS Participants were eligible if they were medical students with no experience in laparoscopy. 24 participants were recruited and finished the study. RESULTS The mental training group maintained significantly better GRS scores at 16 months for PT (mean score 24.6 [95% CI: 21-28.25]) and CC (mean score 22.5 [18.4-26.6]) (both p < 0.01) and performed faster in the latter (261 seconds [Std. Dev 116] vs. 427 seconds [SD 132] vs. 368 seconds [SD 78]) compared to the other groups (p = 0.004). Longitudinally, mental training had a significant effect on TOPS scores and procedural times (p < 0.001 and p = 0.005, respectively). CONCLUSION In addition to short time efficacy, our study is the first to ascertain a positive long-term effect of mental training on manual and cognitive skills and might be a useful and cost-effective tool in surgical education.
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Affiliation(s)
- Julia C Kaulfuss
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Luis A Kluth
- Department of Urology, Goethe University Hospital Frankfurt, Frankfurt, Germany
| | - Phillip Marks
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Margit Fisch
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Felix K H Chun
- Department of Urology, Goethe University Hospital Frankfurt, Frankfurt, Germany
| | - Christian P Meyer
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Thompson JW, Thompson EL, Sanghrajka AP. The future of orthopaedic surgical education: Where do we go now? Surgeon 2021; 20:e86-e94. [PMID: 34217617 DOI: 10.1016/j.surge.2021.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 05/04/2021] [Accepted: 05/14/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION COVID-19 will undoubtedly change the future landscape of medical and surgical education. The economic and environmental advantages of virtual learning are clear, while access to a wider range of resources and subject specialists makes the adoption of virtual learning within surgical education an attractive prospect. AIMS This literature review aims to evaluate evidence on the effectiveness of virtual education in orthopaedics and how we might implement positive changes to educational practice in the future, as a result of lessons learned during the COVID-19 pandemic. METHODOLOGY We performed a review of the literature reporting on efficacy of learning outcomes achieved as a result of virtual education within orthopaedic surgery. Electronic searches were performed using NICE healthcare databases from the date of inception to March 2021. Relevant studies were identified, data extracted, and qualitative synthesis performed. RESULTS 14 manuscripts with a total of 1548 participants (orthopaedic trainees or medical students) were included for analysis. Nine studies (n = 1109) selected compared e-learning to conventional learning material (control group). All nine studies reported significantly higher outcome scores for e-learning participants compared to control participants (p < 0.001 to p < 0.05). The remaining studies compared blended e-learning approaches or evaluated pre/post intervention improvements in learning outcomes. All studies demonstrated a significant improvement in learning outcomes (p < 0.0001 to p < 0.01). The majority of studies (64%) used a blended approach. No studies were identified reporting efficacy of webinars or videoconferencing within orthopaedic education. CONCLUSION A blended approach, combining virtual teaching, face-to-face instruction and distance learning tools, based on the evidence we have provided, would improve the quality of knowledge reception and retention, and learner satisfaction. However, in order to be successful, it is vital that these educational programmes are designed with the needs of the learner in mind, and an awareness of best practice for virtual teaching and learning.
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Affiliation(s)
- Joshua W Thompson
- Department of Trauma and Orthopaedic Surgery, Norfolk and Norwich University Hospitals Foundation Trust, Colney Lane, Norwich, NR4 7UY, United Kingdom.
| | - Emma L Thompson
- Bryan Cave Leighton Paisner LLP, Governor's House, 5 Laurence, Pountney Hill, London, EC4R 0BR, United Kingdom.
| | - Anish P Sanghrajka
- Department of Trauma and Orthopaedic Surgery, Norfolk and Norwich University Hospitals Foundation Trust, Colney Lane, Norwich, NR4 7UY, United Kingdom.
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Examining the impact of COVID-19 restrictions on the operative volumes of US general surgery residents. Surgery 2021; 171:354-359. [PMID: 34247838 PMCID: PMC8196325 DOI: 10.1016/j.surg.2021.06.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/14/2021] [Accepted: 06/01/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND In March 2020, the COVID-19 virus global pandemic forced healthcare systems to institute regulations including the cancellation of elective surgical cases, which likely decreased resident operative experience. The objective of this study was to determine whether the COVID-19 pandemic affected operative experiences of US general surgery residents. METHODS The operative experience of general surgery residents was examined nationally and locally. Aggregate Accreditation Council for Graduate Medical Education (ACGME) case logs for 2018 to 2019 (pre-COVID) and 2019 to 2020 (COVID) graduates were compared using national mean cumulative operative volume for total major and surgeon chief cases. Locally, ACGME case logs were used to analyze the operative experience among residents at a single, academic center. Average operative volumes per month per resident during peak COVID-19 quarantine months were compared with those the previous year. RESULTS Compared with 2019 graduates, 2020 graduates completed 1.5% fewer total major cases (1055 ± 155 vs 1071 ± 150, P = .011). This was most evident during chief year, with 8.4% fewer surgeon chief cases logged in 2020 compared with 2019 (264 ± 67 vs 289 ± 69, P < .001). Institutional data revealed that during the peak of the pandemic, residents across all levels completed 42.5% fewer total major operations (12 ± 11 vs 20 ± 14, P < .001). This effect was more pronounced among junior residents compared with senior and chief residents. CONCLUSION The COVID-19 pandemic was associated with decreased resident case volume. The ramifications of the COVID-19 pandemic for operative competency and autonomy should be carefully examined.
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Grsic K, Malic M, Bilos J. 2D and 3D Video of thyroid surgery-right thyroid lobectomy (with Video). Eur Ann Otorhinolaryngol Head Neck Dis 2021; 138 Suppl 2:39-40. [PMID: 34116949 DOI: 10.1016/j.anorl.2021.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/07/2021] [Accepted: 03/30/2021] [Indexed: 10/21/2022]
Affiliation(s)
- K Grsic
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Centre Zagreb, Zagreb, Croatia.
| | - M Malic
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - J Bilos
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
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Raja BS, Choudhury AK, Paul S, Rajkumar S, Kalia RB. Online educational resources for orthopaedic residency-a narrative review. INTERNATIONAL ORTHOPAEDICS 2021; 45:1911-1922. [PMID: 34080048 PMCID: PMC8172179 DOI: 10.1007/s00264-021-05101-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 05/25/2021] [Indexed: 11/28/2022]
Abstract
Purpose Residency programs in the medical education field are considered the keystone in the development of aptitude and skills required for practice. With the worldwide current scenario of the COVID-19 pandemic, there has been a shift in the paradigm especially in the teaching of the residents from face-to-face classes to more and more online sessions. The purpose of this study is to present a compendium of knowledge-providing sites, smartphone applications (apps), YouTube channels, and podcasts that can provide better online resource management for students in the field of orthopaedics. Methods Search terms were used for making a list of various online resources which can be of help during orthopaedic residency. An initial list of the selected websites, smartphone apps, podcasts, and YouTube channels was made. The corresponding author with years of teaching experience and faculty for post-graduate and fellowship training programs then selected the final list. Results A list of 16 websites with brief points on their content and online address along with the availability of free or paid content was identified as being appropriate. A total of 39 apps available for android/apple smartphones, nine podcasts, and 11 YouTube channels were also identified as being extremely useful and have been discussed elaborately in this article. Conclusion Online educational tools are of immense importance in imparting adequate knowledge to an orthopaedic resident and act as an adjunct to conventional teaching methods. This article focuses on presenting various online educational resources in a simple yet concise way, which may be beneficial for the current generation of residents especially in this current time of unprecedented COVID-19 pandemic.
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Affiliation(s)
- Balgovind S Raja
- Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India
| | | | - Souvik Paul
- Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India
| | - Surjalal Rajkumar
- Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India
| | - R B Kalia
- Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India.
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Mayo I, Manivannan S, Bisson J, Leach P, Zaben M. YouTube as a neurosurgical training tool for the insertion of external ventricular drain. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2020.101079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Forgione A, Guraya SY, Diana M, Marescaux J. Intraoperative and postoperative complications in colorectal procedures: the role of continuous updating in medicine. Minerva Surg 2021; 76:350-371. [PMID: 33944515 DOI: 10.23736/s2724-5691.21.08638-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Accepting surgical complications, especially those related to the learning curve, as unavoidable events in colorectal procedures, is like accepting to fly onboard an aircraft with a 10 to 20% chance of not arriving at final destination. Under this condition, it is very likely that the aviation industry and the concurrent reshaping of the world and of our lives would have not been possible in the absence of high reliability and reproducibility of safe flights. It's hard to imagine surgery without any intraoperative and/or postoperative complications. Nevertheless, there is a plenty of room for improvement by simply adopting what has been explicitly and scientifically demonstrated; training outside of the OR, usage of modern information technologies and application of evidence-based perioperative care protocols. Additionally, the possibility to objectively measure and monitor the technical and even non-technical skills and competencies of individual surgeons and even of OR teams through the application of structured and validated assessment tools can finally put an end to the self-referential, purely hierarchical, and indeed extremely unreliable process of being authorized or not to perform operations on patients. Last but not least, a wide range of new technologies spanning from augmented imaging modalities, virtual reality for intraoperative guidance, improved robotic manipulators, artificial intelligence to assist in preoperative patient specific risk assessment, and intraoperative decision-making has the potential to tackle several hidden roots of surgical complications.
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Affiliation(s)
- Antonello Forgione
- Advanced International Mininvasive Surgery (AIMS) Academy, Milan, Italy -
| | - Salman Y Guraya
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Michele Diana
- IRCAD, Research Institute against Digestive Cancer, Strasbourg, France.,Photonics for Health, ICube Lab, University of Strasbourg, Strasbourg, France.,Department of General, Digestive and Endocrine Surgery, University Hospital of Strasbourg 1, Strasbourg, France
| | - Jacques Marescaux
- IRCAD, Research Institute against Digestive Cancer, Strasbourg, France
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Schmitz SM, Schipper S, Lemos M, Alizai PH, Kokott E, Brozat JF, Neumann UP, Ulmer TF. Development of a tailor-made surgical online learning platform, ensuring surgical education in times of the COVID19 pandemic. BMC Surg 2021; 21:196. [PMID: 33865366 PMCID: PMC8052764 DOI: 10.1186/s12893-021-01203-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/09/2021] [Indexed: 11/17/2022] Open
Abstract
Background During the worldwide COVID-19 pandemic, the quality of surgical education experiences sudden major restrictions. Students’ presence in the operating theater and on wards is reduced to a bare minimum and face-to-face teaching is diminished. Aim of this study was therefore to evaluate alternative but feasible educational concepts, such as an online-only-platform for undergraduates. Objective A new online platform for undergraduate surgical education was implemented. A virtual curriculum for online-only education was designed. Methods
A video-based online platform was designed. Following this, a cohort of medical students participating in a (voluntary) surgical course was randomized into a test and control group. Prior to conducting a written exam, students in the test group prepared using the video platform. Students in the control group prepared with standard surgical text books. Results of the exam were used to compare educational means. Results Students in the test group preparing through the video-based online platform reached significantly higher scores in the written exams (p = 0.0001) than students of the control group. A trend towards reduced preparation time that did not reach statistical significance was detectable in the test group (p = 0.090). Scores of “perceived workload” and “desire to become a surgeon” offered no differences between the groups. (p = 0.474 and 1.000). Conclusions An online-only, virtual curriculum proved feasible for surgical education in undergraduates. While blended learning concepts were applied in both groups, only the test group had access to case-based videos of surgical procedures and scored significantly better in the written exams. Thus, video-based virtual education offers a realistic alternative to face-to-face teaching or conventional text books in times of restricted access to the operating theatre.
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Affiliation(s)
- Sophia M Schmitz
- Department for General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Sandra Schipper
- Department for General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany.,Department of Nanomedicine and Theranostics, Institute for Experimental Molecular Imaging, RWTH University Clinic and Helmholtz Institute for Biomedical Engineering, Aachen, Germany
| | - Martin Lemos
- Audiovisual Media Center, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Patrick H Alizai
- Department for General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Elda Kokott
- Department for General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Jonathan F Brozat
- Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany
| | - Ulf P Neumann
- Department for General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany.,Department of Surgery, Maastricht University Medical Centre (MUMC), Maastricht, Netherlands
| | - Tom F Ulmer
- Department for General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany.,Department of Surgery, Maastricht University Medical Centre (MUMC), Maastricht, Netherlands
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Parekh U, Gupta S. LIVE FM (lecture improvised with video elements in forensic medicine): does a video worth a thousand pictures? A comparative study in medical education. J Vis Commun Med 2021; 44:45-51. [PMID: 33784922 DOI: 10.1080/17453054.2021.1901057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Forensic education should be fully conversant with a scientific theory of how students learn. By and large, the traditional model of education is widely accepted. 'Difficult-to-learn' areas in forensic medicine are the challenges to students as well as teachers. An innovative modality 'lectures improvised with video elements' was used by authors in the undergraduate medical education program of Forensic Medicine in order to facilitate active learning. Evaluation of this approach has established a positive impact on student's spatial ability, reasoning ability, and memory skills. Intrinsic cognitive load on working memory was reduced to a certain extent. With compare to the static pictures, video usage significantly helps to comprehend the difficult content of the learning. Students found the experience interesting and very ardent to use it again.
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Affiliation(s)
- Utsav Parekh
- Department of Forensic Medicine, Pramukhswami Medical College, Karamsad, India
| | - Sanjay Gupta
- Department of Forensic Medicine, Pramukhswami Medical College, Karamsad, India
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Humm G, Harries RL, Stoyanov D, Lovat LB. Supporting laparoscopic general surgery training with digital technology: The United Kingdom and Ireland paradigm. BMC Surg 2021; 21:123. [PMID: 33685437 PMCID: PMC7941971 DOI: 10.1186/s12893-021-01123-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/25/2021] [Indexed: 12/20/2022] Open
Abstract
Surgical training in the UK and Ireland has faced challenges following the implementation of the European Working Time Directive and postgraduate training reform. The health services are undergoing a digital transformation; digital technology is remodelling the delivery of surgical care and surgical training. This review aims to critically evaluate key issues in laparoscopic general surgical training and the digital technology such as virtual and augmented reality, telementoring and automated workflow analysis and surgical skills assessment. We include pre-clinical, proof of concept research and commercial systems that are being developed to provide solutions. Digital surgical technology is evolving through interdisciplinary collaboration to provide widespread access to high-quality laparoscopic general surgery training and assessment. In the future this could lead to integrated, context-aware systems that support surgical teams in providing safer surgical care.
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Affiliation(s)
- Gemma Humm
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 43-45 Foley Street, London, W1W 7TY, UK.
- Division of Surgery and Interventional Science, University College London, London, UK.
| | | | - Danail Stoyanov
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 43-45 Foley Street, London, W1W 7TY, UK
- Department of Computer Science, University College London, London, UK
| | - Laurence B Lovat
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 43-45 Foley Street, London, W1W 7TY, UK
- Division of Surgery and Interventional Science, University College London, London, UK
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Sell NM, Cassidy DJ, McKinley SK, Petrusa E, Gee DW, Antonoff MB, Phitayakorn R. A Needs Assessment of Video-based Education Resources Among General Surgery Residents. J Surg Res 2021; 263:116-123. [PMID: 33652173 DOI: 10.1016/j.jss.2021.01.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 01/10/2021] [Accepted: 01/31/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Video-based education (VBE) is an effective tool for knowledge and skill acquisition for medical students, but its utility is less clear for resident physicians. We sought to determine how to incorporate VBE into a general surgery resident operative curriculum. METHODS We conducted a single-institution, survey-based needs assessment of general surgery residents to determine desired content and format of an operative VBE module. RESULTS The response rate was 84% (53/63), with 66% senior (postgraduate year ≥3) resident respondents. VBE was the most commonly cited resource that residents used to prepare for an operation (93%) compared with surgical textbooks (89%) and text-based website content (57%). Junior residents were more likely to utilize text-based website content than senior residents (P < 0.01). The three most important operative video components were accuracy, length, and cost. Senior residents significantly preferred videos that were peer-reviewed (P < 0.05) and featured attending surgeons whom they knew (P = 0.03). A majority of residents (59%) believed 5-10 min is the ideal length of an operative video. Across all postgraduate year levels, residents indicated that detailed instruction of each operative step was the most important content of a VBE module. Senior residents believed that the overall indications and details of each step of the operation were the most important contents of VBE for a junior resident. CONCLUSIONS At this institution, general surgery residents preferentially use VBE resources for operative preparation. A centralized, standardized operative resource would likely improve resident studying efficiency, but would require personalized learning options to work for both junior and senior surgery residents.
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Affiliation(s)
- Naomi M Sell
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Douglas J Cassidy
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Sophia K McKinley
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Emil Petrusa
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Denise W Gee
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Mara B Antonoff
- Department of Thoracic and Cardiovascular Surgery, MD Anderson Cancer Center, Houston, Texas
| | - Roy Phitayakorn
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
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Mazer L, Varban O, Montgomery JR, Awad MM, Schulman A. Video is better: why aren't we using it? A mixed-methods study of the barriers to routine procedural video recording and case review. Surg Endosc 2021; 36:1090-1097. [PMID: 33616730 DOI: 10.1007/s00464-021-08375-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/09/2021] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Video-based case review for minimally invasive surgery is immensely valuable for education and quality improvement. Video review can improve technical performance, shorten the learning curve, disseminate new procedures, and improve learner satisfaction. Despite these advantages, it is underutilized in many institutions. So far, research has focused on the benefits of video, and there is relatively little information on barriers to routine utilization. METHODS A 36-question survey was developed on video-based case review and distributed to the SAGES email list. The survey included closed and open-ended questions. Numeric responses and Likert scales were compared with t-test; open-ended responses were reviewed qualitatively through rapid thematic analysis to identify themes and sub-themes. RESULTS 642 people responded to the survey for a response rate of 11%. 584 (91%) thought video would improve the quality of educational conferences. 435 qualitative responses on the value of video were analyzed, and benefits included (1) improved understanding, (2) increased objectivity, (3) better teaching, and (4) better audience engagement. Qualitative comments regarding specific barriers to recording and editing case video identified challenges at all stages of the process, from (1) the decision to record a case, (2) starting the recording in the OR, (3) transferring and storing files, and (4) editing the file. Each step had its own specific challenges. CONCLUSION Minimally invasive surgeons want to increase their utilization of video-based case review, but there are multiple practical challenges to overcome. Understanding these barriers is essential in order to increase use of video for education and quality improvement.
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Affiliation(s)
- Laura Mazer
- Department of Surgery, Division of Minimally Invasive Surgery, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA.
| | - Oliver Varban
- Department of Surgery, Division of Minimally Invasive Surgery, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - John R Montgomery
- Department of Surgery, Division of Minimally Invasive Surgery, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - Michael M Awad
- Department of Surgery, Division of Minimally Invasive Surgery, Washington University School of Medicine, St Louis, USA
| | - Allison Schulman
- Department of Gastroenterology, Division of Interventional Gastroenterology, University of Michigan, Ann Arbor, USA
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Bogomolova K, van Merriënboer JJG, Sluimers JE, Donkers J, Wiggers T, Hovius SER, van der Hage JA. The effect of a three-dimensional instructional video on performance of a spatially complex procedure in surgical residents in relation to their visual-spatial abilities. Am J Surg 2021; 222:739-745. [PMID: 33551116 DOI: 10.1016/j.amjsurg.2021.01.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/17/2021] [Accepted: 01/23/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The effect of three-dimensional (3D) vs. two-dimensional (2D) video on performance of a spatially complex procedure and perceived cognitive load were examined among residents in relation to their visual-spatial abilities (VSA). METHODS In a randomized controlled trial, 108 surgical residents performed a 5-Flap Z-plasty on a simulation model after watching the instructional video either in a 3D or 2D mode. Outcomes included perceived cognitive load measured by NASA-TLX questionnaire, task performance assessed using Observational Clinical Human Reliability Analysis and the percentage of achieved safe lengthening of the scar. RESULTS No significant differences were found between groups. However, when accounted for VSA, safe lengthening was achieved significantly more often in the 3D group and only among individuals with high VSA (OR = 6.67, 95%CI: 1.23-35.9, p = .027). CONCLUSIONS Overall, 3D instructional videos are as effective as 2D videos. However, they can be effectively used to enhance learning in high VSA residents.
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Affiliation(s)
- Katerina Bogomolova
- Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, the Netherlands; Center for Innovation of Medical Education, Leiden University Medical Center, Hippocratespad 21, 2333 ZD, Leiden, the Netherlands.
| | - Jeroen J G van Merriënboer
- Department of Educational Development and Research, Faculty of Health, Medicine & Life Sciences, Maastricht University, Universiteitssingel 60, UNS60 6229 ER, Maastricht, the Netherlands
| | - Jan E Sluimers
- Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, the Netherlands
| | - Jeroen Donkers
- Department of Educational Development and Research, Faculty of Health, Medicine & Life Sciences, Maastricht University, Universiteitssingel 60, UNS60 6229 ER, Maastricht, the Netherlands
| | - Theo Wiggers
- Incision Academy, Mauritskade 63, 1092 AD, Amsterdam, the Netherlands
| | - Steven E R Hovius
- Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands
| | - Jos A van der Hage
- Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, the Netherlands; Center for Innovation of Medical Education, Leiden University Medical Center, Hippocratespad 21, 2333 ZD, Leiden, the Netherlands
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van Dalen AS, van Haperen M, Swinkels JA, Grantcharov TP, Schijven MP. Development of a Model for Video-Assisted Postoperative Team Debriefing. J Surg Res 2021; 257:625-635. [DOI: 10.1016/j.jss.2020.07.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/14/2020] [Accepted: 07/17/2020] [Indexed: 01/09/2023]
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The lasting footprint of COVID-19 on surgical education: A resident and attending perspective on the global pandemic. Am J Surg 2020; 222:473-480. [PMID: 33413877 PMCID: PMC7773322 DOI: 10.1016/j.amjsurg.2020.12.046] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/21/2020] [Accepted: 12/23/2020] [Indexed: 11/30/2022]
Abstract
Background The COVID-19 pandemic has impacted surgical training nationwide. Our former curricula will likely not return, and training will need to adapt, so we are able to graduate residents of the same caliber as prior to the pandemic. Methods A survey evaluating perceptions of changes made in surgical training was conducted on surgery residents and attendings. Results Disaster medicine training has become more relevant and 85% residents and 75% attendings agreed it should be incorporated into the curriculum. Safety of family was the most significant concern of residents. Virtual curriculum was perceived to be acceptable by 82% residents and only 22% attendings (p < 0.01). Residents (37%) were less concerned than attendings (61%) of falling behind on their overall training (p = 0.04). Both groups agreed operative skills would be adversely affected (56%vs72%; p = 0.37). Conclusions To maintain an effective surgical curriculum, programs will need to implement new educational components to better prepare residents to become surgeons of the future.
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Bradley K, Godin M, Ascano FA. Game Changer: Integrating Technology to Bring Competency and Policy to Life. J Contin Educ Nurs 2020; 51:544-546. [PMID: 33232501 DOI: 10.3928/00220124-20201113-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Using technology can transform methodologies for staff education and clinical practice while addressing different learning styles and competency needs. Video can enhance competency standardization and policy use. Videos increase staff engagement and level of confidence when supplementing clinical education and policy management. [J Contin Educ Nurs. 2020;51(12):544-546.].
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Schaffir J, Strafford K, Worly B, Traugott A. Challenges to Medical Education on Surgical Services During the COVID-19 Pandemic. MEDICAL SCIENCE EDUCATOR 2020; 30:1667-1671. [PMID: 32904384 PMCID: PMC7455508 DOI: 10.1007/s40670-020-01072-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Jonathan Schaffir
- Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, 395 West 12th Avenue, 5th floor, Columbus, OH USA
| | - Katherine Strafford
- Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, 395 West 12th Avenue, 5th floor, Columbus, OH USA
| | - Brett Worly
- Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, 395 West 12th Avenue, 5th floor, Columbus, OH USA
| | - Amber Traugott
- Department of Surgery, The Ohio State University College of Medicine, 395 West 12th Avenue, 6th floor, Columbus, OH USA
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Cassidy DJ, Mullen JT, Gee DW, Joshi AR, Klingensmith ME, Petrusa E, Phitayakorn R. #SurgEdVidz: Using Social Media to Create a Supplemental Video-Based Surgery Didactic Curriculum. J Surg Res 2020; 256:680-686. [DOI: 10.1016/j.jss.2020.04.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 11/30/2022]
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Lee JA, Close MF, Liu YF, Rowley MA, Isaac MJ, Costello MS, Nguyen SA, Meyer TA. Using Intraoperative Recordings to Evaluate Surgical Technique and Performance in Mastoidectomy. JAMA Otolaryngol Head Neck Surg 2020; 146:893-899. [PMID: 32780790 DOI: 10.1001/jamaoto.2020.2063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Otolaryngology residency programs currently lack rigorous methods for assessing surgical skill and often rely on biased tools of evaluation. Objectives To evaluate which techniques used in mastoidectomy can serve as indicators of surgeon level (defined as the level of training) and whether these determinations of technique can be made based solely on the movement of the drill head or suction. Design, Setting, and Participants In this prospective, observational study conducted from January 1, 2015, to December 31, 2019, at a single tertiary care institution, 3 independent observers made blinded evaluations on 24 intraoperative recordings of surgeons (6 junior residents, 4 senior residents, and 2 attending surgeons) performing mastoidectomies. Main Outcomes and Measures Observers assessed drill stroke count, drilling efficiency, stroke pattern, use of suction and irrigation, and estimated surgeon level. Assessments were made on both original videos and animated videos that show only the path of the burr head or suction as dots against a white background. Results Among the 24 recorded mastoidectomies performed by the 12 study surgeons, intraclass correlation was excellent for original video assessment of drill stroke count (0.98 [95% CI, 0.97-1.00]), use of suction (0.75 [95% CI, 0.52-0.89]), use of irrigation (0.83 [95% CI, 0.66-0.92]), and estimated surgeon level (0.82 [95% CI, 0.64-0.92]) and fair for drilling efficiency (0.54 [95% CI, 0.09-0.79]) and stroke pattern (0.49 [95% CI, -0.02 to 0.76]). Intraclass correlation was excellent for animated video assessment of drill stroke count per unit time (0.98 [95% CI, 0.96-0.99]) and drilling efficiency (0.80 [95% CI, 0.60-0.91]), good for stroke pattern (0.68 [95% CI, 0.38-0.85]) and estimated surgeon level (based on path of drill) (0.69 [95% CI, 0.38-0.85]), and fair for use of suction (0.58 [95% CI, 0.16-0.80]) and estimated surgeon level (based on path of suction) (0.58 [95% CI, 0.17-0.80]). On evaluation of original videos, junior residents had lower drill stroke count compared with senior residents and attending surgeons (6.0 [interquartile range (IQR), 3.0-8.0] vs 9.5 [IQR, 5.0-13.0] vs 10.5 [IQR, 5.0-17.8]; η2 = 0.14 [95% CI, 0.01-0.28]). On evaluation of animated videos, junior residents also had lower drill stroke count compared with senior residents and attending surgeons (6.0 [IQR, 4.0-9.0] vs 10.5 [IQR, 10.0-13.8] vs 10.5 [IQR, 4.3-21.0]; η2 = 0.19 [95% CI, 0.04-0.33]). Compared with junior and senior residents, attending surgeons had higher median ratings of drilling efficiency (original videos: junior residents, 4.0 [IQR, 3.0-4.0]; senior residents, 4.0 [IQR, 3.0-4.8]; attending surgeons, 5.0 [IQR, 4.3-5.0]; η2 = 0.23 [95% CI, 0.06-0.37]; animated videos: junior residents, 4.0 [IQR, 3.0-4.0]; senior residents, 3.0 [IQR, 2.0-4.0]; attending surgeons, 5.0 [IQR, 4.0-5.0]; η2 = 0.25 [95% CI, 0.08-0.39]) and stroke pattern (original videos: junior residents, 4.0 [IQR, 3.0-4.0]; senior residents, 4.0 [IQR, 3.0-4.8]; attending surgeons, 5.0 [IQR, 5.0-5.0]; η2 = 0.17 [95% CI, 0.03-0.31]; animated videos: junior residents, 4.0 [IQR, 3.0-4.0]; senior residents, 4.0 [IQR, 2.0-4.0]; attending surgeons, 5.0 [IQR, 5.0-5.0]; η2 = 0.15 [95% CI, 0.02-0.29]). Conclusions and Relevance This study suggests that observation of intraoperative mastoidectomy recordings is a feasible method of evaluating surgeon level. Reasonable indicators of surgeon level include the drill stroke count, drilling efficiency, stroke pattern, and use of the suction irrigator. Observing the path of the drill alone is sufficient to appreciate differences in drilling technique but not sufficient to accurately determine surgeon level. Intraoperative recordings can serve as a useful addition to resident education and evaluation.
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Affiliation(s)
- Joshua A Lee
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Michaela F Close
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Yuan F Liu
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - M Andrew Rowley
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Mitchell J Isaac
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Mark S Costello
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Ted A Meyer
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
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Simon F, Peer S, Michel J, Bruce IA, Cherkes M, Denoyelle F, Fagan JJ, Harish M, Hong P, James A, Jia H, Krishnan PV, Maunsell R, Modi VK, Nguyen Y, Parikh SR, Patel N, Pullens B, Russo G, Rutter MJ, Sargi Z, Shaye D, Sowerby LJ, Yung M, Zdanski CJ, Teissier N, Fakhry N. IVORY Guidelines (Instructional Videos in Otorhinolaryngology by YO-IFOS): A Consensus on Surgical Videos in Ear, Nose, and Throat. Laryngoscope 2020; 131:E732-E737. [PMID: 33270236 PMCID: PMC7891442 DOI: 10.1002/lary.29020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/10/2020] [Accepted: 07/20/2020] [Indexed: 11/16/2022]
Abstract
Objectives/Hypothesis Otolaryngology instructional videos available online are often of poor quality. The objective of this article was to establish international consensus recommendations for the production of educational surgical videos in otolaryngology. Study Design DELPHI survey. Methods Twenty‐seven international respondents participated in this study from 12 countries. Consensus was reached after three rounds of questionnaires following the Delphi methodology. The proposals having reached the 80% agreement threshold in the third round were retained. Results The main recommendations are as follows: 1) Ethics: patients must be anonymized and unrecognizable (apart from plastic surgery if necessary). A signed authorization must be obtained if the person is recognizable. 2) Technical aspects: videos should be edited and in high‐definition (HD) quality if possible. Narration or subtitles and didactic illustrations are recommended. 3) Case presentation: name of pathology and procedure must be specified; the case should be presented with relevant workup. 4) Surgery: surgical procedures should be divided into several distinct stages and include tips and pitfalls. Pathology should be shown if relevant. Key points should be detailed at the end of the procedure. 5) Organ‐specific: type of approach and bilateral audiometry should be specified in otology. Coronal plane computed tomography scans should be shown in endonasal surgery. It is recommended to show pre‐ and postoperative videos in voice surgery and preoperative drawings and photos of scars in plastic surgery, as well as the ventilation method in airway surgery. Conclusions International recommendations have been determined to assist in the creation and standardization of educational surgical videos in otolaryngology and head and neck surgery. Level of Evidence 5 Laryngoscope, 131:E732–E737, 2021
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Affiliation(s)
- François Simon
- Department of Pediatric Otolaryngology, Necker-Sick Children's Hospital, AP-HP-University of Paris, Paris, France
| | - Shazia Peer
- Division of Otolaryngology, University of Cape Town and Red Cross Children's Hospital, Rondebosch, South Africa
| | - Justin Michel
- Department of Oto-Rhino-Laryngology-Head and Neck Surgery, Aix Marseille University, APHM, University Institute of Industrial Thermal Systems, La Conception University Hospital, Marseille, France
| | - Iain A Bruce
- Division of Infection, Immunity, and Respiratory Medicine, Royal Manchester Children's Hospital, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Maryana Cherkes
- Departement of Otolaryngology, Lviv City Children's Clinical Hospital, Lviv National Medical University, Lviv, Ukraine
| | - Françoise Denoyelle
- Department of Pediatric Otolaryngology, Necker-Sick Children's Hospital, AP-HP-University of Paris, Paris, France
| | - Johannes J Fagan
- Division of Otolaryngology, University of Cape Town and Red Cross Children's Hospital, Rondebosch, South Africa
| | | | - Paul Hong
- Department of Surgery, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Adrian James
- Department of Otolaryngology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Huan Jia
- Department of Otolaryngology-Head Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - P Vijaya Krishnan
- Department of Otorhinolaryngology, Madras Ear Nose and Throat Research Foundation, Chennai, Tamil Nadu, India
| | - Rebecca Maunsell
- Department of Otorhinolaryngology, Faculty of Medical Sciences, State University of Campinas UNICAMP, Campinas, Brazil
| | - Vikash K Modi
- Pediatric Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College/New York-Presbyterian Hospital, New York, New York, U.S.A
| | - Yann Nguyen
- Department of Otorhinolaryngology, Pitié-Salpêtrière Hospital, Robotic and surgical innovation research group, Inserm, Pasteur, "Innovative Technologies and Translational Therapeutics for Deafness," Hearing Institute, Sorbonne University, AP-HP, Paris, France
| | - Sanjay R Parikh
- Seattle Children's Hospital, University of Washington, Seattle, Washington, U.S.A
| | - Nirmal Patel
- Department of Otolaryngology-Head and Neck Surgery, University of Sydney and Macquarie University, Sydney, New South Wales, Australia
| | - Bas Pullens
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Gennaro Russo
- Department of Otorhinolaryngology, Monaldi Hospital, Naples, Italy
| | - Michael J Rutter
- Division of Pediatric Otolaryngology, Aerodigestive and Esophageal Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | - Zoukaa Sargi
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
| | - David Shaye
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Leigh J Sowerby
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
| | - Matthew Yung
- Department of Otolaryngology, Ipswich Hospital, Colchester, United Kingdom
| | - Carlton J Zdanski
- Division of Pediatric Otolaryngology/Head and Neck Surgery, Department of Otolaryngology/Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, U.S.A
| | - Natacha Teissier
- Department of Pediatric Otolaryngology, Robert-Debré Hospital, AP-HP-University of Paris, Paris, France
| | - Nicolas Fakhry
- Department of Oto-Rhino-Laryngology-Head and Neck Surgery, Aix Marseille University, APHM, Language and Speech Laboratory, La Conception University Hospital, Marseille, France
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Halim J, Jelley J, Zhang N, Ornstein M, Patel B. The effect of verbal feedback, video feedback, and self-assessment on laparoscopic intracorporeal suturing skills in novices: a randomized trial. Surg Endosc 2020; 35:3787-3795. [PMID: 32804266 DOI: 10.1007/s00464-020-07871-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 08/05/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Laparoscopic skill acquisition involves a steep learning curve and laparoscopic suturing is an exceptionally challenging task. By improving the way feedback is given, trainees can learn these skills more effectively. This study aims to establish the most effective form of structured feedback on laparoscopic suturing skill acquisition in novices, by comparing the effects of expert verbal feedback, video review with expert feedback (video feedback), and video review with self-assessment. METHODS A prospective randomized blinded trial comparing verbal feedback, video feedback, and self-assessment. Novices in laparoscopic surgery were tasked with performing laparoscopic suturing with intracorporeal knot tying. Time was given for practice, and pre- and post-feedback assessments were undertaken. Suturing performance was measured using a task-specific checklist and global ratings. A post-study questionnaire was used to measure participant-perceived confidence, knowledge, and experience levels. RESULTS Fifty-one participants were randomized and allocated equally into the three groups. Performance in all three groups improved significantly from baseline. Video feedback had the largest improvement margin with checklist and global score improvements of 17.1% (± 9.9%) and 14.7% (± 9.3%), respectively. Performance improvements between groups were statistically significant in the global components (p = 0.004) but not the checklist components (p = 0.186). Global score improvement was significantly better in the video feedback group but was statistically insignificant between the self-assessment and verbal feedback groups. Questionnaire responses demonstrated positive results in confidence, knowledge, and experience levels, across all three study groups, with no differences between the groups (p > 0.05). CONCLUSION Structured video feedback facilitates reflection and self-directed learning, which improves the ability to develop proficiency in surgical skills. Combining both self-assessment and video feedback may be beneficial over verbal feedback alone due to the advantages of video review. These techniques should therefore be considered for implementation into surgical education curricula.
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Affiliation(s)
- Jonathan Halim
- Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London, UK.
| | - Joshua Jelley
- Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London, UK
| | - Ningning Zhang
- Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London, UK
| | - Marcus Ornstein
- Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London, UK
| | - Bijendra Patel
- Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London, UK
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Perrone MA, Youssefzadeh K, Serrano B, Limpisvasti O, Banffy M. The Impact of COVID-19 on the Sports Medicine Fellowship Class of 2020. Orthop J Sports Med 2020; 8:2325967120939901. [PMID: 32874996 PMCID: PMC7433378 DOI: 10.1177/2325967120939901] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background: In response to the COVID-19 pandemic, many US health systems suspended elective surgery at the recommendation of the US Surgeon General. This dramatically decreased case volumes for orthopaedic sports medicine fellows at academic institutions. Purpose: To describe how the COVID-19 pandemic has affected the education of the sports medicine fellowship class of 2020 as well as the subsequent effects on their career plans and psychological well-being. Study Design: Cross-sectional study. Methods: A 33-item survey was distributed via email to all American Orthopaedic Society for Sports Medicine (AOSSM) 2020 fellow members on April 22, 2020. Frequencies are presented as raw totals and percentages of respondents. The Fisher exact test was used to determine statistical significance between nominal variables, with significance set at P < .05. Results: Of 210 registered fellows, 101 (48.1%) responded. Before the COVID-19 outbreak, the typical case volume per week for most fellows (47.5%) was 11 to 15 cases. From the enactment of COVID-19 mitigation policies to the date of survey completion, 90.1% of fellows had performed fewer than 20 cases. A total of 32 fellows were presented with redeployment options by their fellowship program, with 10 redeployed mandatorily to other hospital departments. Fellows reported that web-based didactics (n = 100) and web-based journal clubs (n = 72) were utilized as alternative supplements in the absence of clinical education. There were 8 respondents who had either their prior contract or job offer rescinded, while 1 had a signed contract voided. As a result, 6 fellows now plan to matriculate into a previously unplanned fellowship. Also, 10 respondents’ intended practice start date was being delayed by their employer. Respondents whose postfellowship plans were affected were statistically more likely to experience doubts about readiness for practice (58.8% vs 20.3%, respectively; P = .005), anxiety about future career plans (94.4% vs 63.8%, respectively; P = .01), anxiety about their financial situation (86.7% vs 50.8%, respectively; P = .018), stress in personal relationships (58.8% vs 29.9%, respectively; P = .045), and signs or symptoms of depression (41.2% vs 11.1%, respectively; P = .007) compared with those whose plans were not affected. Conclusion: This survey illustrates that during the early stages of the COVID-19 pandemic and the subsequent suspension of elective surgery, there have been downstream effects to this group’s education, careers, board certification timeline, and potentially their social and/or emotional well-being.
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Affiliation(s)
| | | | - Brian Serrano
- Cedars-Sinai Kerlan-Jobe Institute, Los Angeles, California, USA
| | - Orr Limpisvasti
- Cedars-Sinai Kerlan-Jobe Institute, Los Angeles, California, USA
| | - Michael Banffy
- Cedars-Sinai Kerlan-Jobe Institute, Los Angeles, California, USA
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Johnson J, Chung MT, Carron MA, Chan EY, Lin HS, Hotaling J. Novel Changes in Resident Education during a Pandemic: Strategies and Approaches to Maximize Residency Education and Safety. Int Arch Otorhinolaryngol 2020; 24:e267-e271. [PMID: 32754235 PMCID: PMC7394620 DOI: 10.1055/s-0040-1714147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/03/2020] [Indexed: 02/03/2023] Open
Abstract
Introduction The COVID-19 pandemic has led to a reduction in surgical and clinical volume, which has altered the traditional training experience of the otolaryngology resident. Objective To describe the strategies we utilized to maximize resident education as well as ensure patient and staff safety during the pandemic. Methods We developed a system that emphasized three key elements. First and foremost, patient care remained the core priority. Next, clinical duties were restructured to avoid unnecessary exposure of residents. The third component was ensuring continuation of resident education and maximizing learning experiences. Results To implement these key elements, our residency divided up our five hospitals into three functional groups based on geographical location and clinical volume. Each team works for three days at their assigned location before being replaced by the next three-person team at our two busiest sites. Resident teams are kept completely separate from each other, so that they do not interact with those working at other sites. Conclusions Despite the daily challenges encountered as we navigate through the COVID-19 pandemic, our otolaryngology residency program has been able to establish a suitable balance between maintenance of resident safety and well-being without compromise to patient care.
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Affiliation(s)
- Jared Johnson
- Department of Otolaryngology – Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, United States
| | - Michael T. Chung
- Department of Otolaryngology – Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, United States
| | - Michael A. Carron
- Department of Otolaryngology – Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, United States
| | - Eleanor Y. Chan
- Department of Otolaryngology – Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, United States
- Division of Neurotology/Skull Base Surgery, Michigan Ear Institute, Farmington Hills, MI, United States
| | - Ho-Sheng Lin
- Department of Otolaryngology – Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, United States
| | - Jeffrey Hotaling
- Department of Otolaryngology – Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, United States
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Stambough JB, Curtin BM, Gililland JM, Guild GN, Kain MS, Karas V, Keeney JA, Plancher KD, Moskal JT. The Past, Present, and Future of Orthopedic Education: Lessons Learned From the COVID-19 Pandemic. J Arthroplasty 2020; 35:S60-S64. [PMID: 32345564 PMCID: PMC7166110 DOI: 10.1016/j.arth.2020.04.032] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 02/01/2023] Open
Abstract
The COVID-19 global pandemic has upended nearly every medical discipline, dramatically impacted patient care and has had far-reaching effects on surgeon education. In many areas of the country, elective orthopedic surgery has completely stopped to ensure that resources are available for the critically ill and to minimize the spread of disease. COVID-19 is forcing many around the world to re-evaluate existing processes and organizations and adapt to carry out business, of which medicine and education are not immune. Most national and international orthopedic conferences, training programs, and workshops have been postponed or canceled, and we are now critically evaluating the delivery of education to our colleagues as well as residents and fellows. This article describes the evolution of orthopedic education and significant paradigm shifts necessary to continue to teach ourselves and the future leaders of our noble profession.
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Affiliation(s)
- Jeffrey B Stambough
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR
| | | | - Jeremy M Gililland
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT
| | - George N Guild
- Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, GA
| | - Michael S Kain
- Boston Medical Center, Department of Orthopaedic Surgery, Boston University School of Medicine, Boston, MA
| | - Vasili Karas
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL
| | - James A Keeney
- Department of Orthopaedic Surgery, University of Missouri School of Medicine, Columbia, MO
| | - Kevin D Plancher
- Plancher Orthopaedics & Sports, Albert Einstein College of Medicine, New York, NY
| | - Joseph T Moskal
- Department of Orthopaedic Surgery, Virginia Tech Carilion School of Medicine, Roanoke, VA
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Navarra G, Komaei I, Currò G, Angrisani L, Bellini R, Cerbone MR, Di Lorenzo N, De Luca M, Foletto M, Gentileschi P, Musella M, Nannipieri M, Piazza L, Olmi S, Pilone V, Raffaelli M, Sarro G, Vitiello A, Zappa MA, Foschi D. Bariatric surgery and the COVID-19 pandemic: SICOB recommendations on how to perform surgery during the outbreak and when to resume the activities in phase 2 of lockdown. Updates Surg 2020; 72:259-268. [PMID: 32514743 PMCID: PMC7278242 DOI: 10.1007/s13304-020-00821-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/22/2020] [Indexed: 12/22/2022]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its related disease, coronavirus disease 2019 (COVID-19), has been rapidly spreading all over the world and is responsible for the current pandemic. The current pandemic has found the Italian national health system unprepared to provide an appropriate and prompt response, heavily affecting surgical activities. Based on the limited data available in the literature and personal experiences, the Società Italiana di Chirurgia dell’OBesità e Malattie Metaboliche (SICOB) provides recommendations regarding the triage of bariatric surgical procedures during the COVID-19 pandemic defining a dedicated path for surgery in morbidly obese patients with known or suspected COVID-19 who may require emergency operations. Finally, the current paper delineates a strategy to resume outpatient visits and elective bariatric surgery once the acute phase of the pandemic is over. Models developed during the COVID-19 crisis should be integrated into hospital practices for future use in similar scenarios. Surgeons are presented with a golden opportunity to embrace systemic change and to drive their professional future.
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Affiliation(s)
- Giuseppe Navarra
- Department of General Surgery, University Hospital of Messina "G. Martino", Messina, Italy
| | - Iman Komaei
- Department of General Surgery, University Hospital of Messina "G. Martino", Messina, Italy.
| | - Giuseppe Currò
- Department of General Surgery, University Hospital of Messina "G. Martino", Messina, Italy
| | - Luigi Angrisani
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | | | | | - Nicola Di Lorenzo
- Department of Surgical Sciences, University of Rome "Tor Vergata", Rome, Italy
| | - Maurizio De Luca
- Division of General Surgery, San Valentino Hospital, Montebelluna, Italy
| | | | | | - Mario Musella
- Advanced Biomedical Sciences Department, University of Naples "Federico II", Naples, Italy
| | - Monica Nannipieri
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Luigi Piazza
- Department of General and Emergency Surgery, ARNAS "G. Garibaldi", Catania, Italy
| | - Stefano Olmi
- Centre of Bariatric Surgery, San Marco Hospital, Zingonia, Italy
| | - Vincenzo Pilone
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Marco Raffaelli
- Endocrine and Metabolic Surgery Unit, A., Gemelli University Hospital IRCCS, Rome, Italy
| | | | - Antonio Vitiello
- Department of Surgery, University Hospital of Naples "Federico II", Naples, Italy
| | | | - Diego Foschi
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
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Abstract
BACKGROUND Modern total hip arthroplasty has seen an unfortunate increase in proportional implant failures secondary to adverse local tissue reactions (ALTRs) secondary to wear of metal-on-metal (MoM) bearings and mechanically assisted crevice corrosion (MACC) related to corrosion at implant junctions and tapers. The purpose of this study is to describe the appropriate choice of metal ion testing and evaluation of those levels to identify failed total hip arthroplasty implants containing cobalt and chromium. METHODS When presented with an arthroplasty of concern, the surgeon must determine what metal ion levels to obtain and then incorporate those levels into a treatment algorithm. Patients with painful hip arthroplasties are evaluated for chromium and cobalt by obtaining whole blood and synovial metal levels. RESULTS Synovial fluid cobalt had the highest correlation with ALTR compared with the other tests, with a threshold of 19.75 ng/ml, with a specificity of 89%, if the cobalt-to-chromium ratio is greater than 1.4 ng/ml in a metal on polyethylene hip, with a sensitivity of 95%. CONCLUSION The interpretation of whole blood metal ions is a key component of the algorithm in treating the symptomatic hip arthroplasty but is not to be used in a vacuum.
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Srinivasa K, Chen Y, Henning MA. The role of online videos in teaching procedural skills to post-graduate medical learners: A systematic narrative review. MEDICAL TEACHER 2020; 42:689-697. [PMID: 32174211 DOI: 10.1080/0142159x.2020.1733507] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Objective: Online videos are commonly used in medical education. The aim of this review was to investigate the role of online instructional videos in teaching procedural skills to postgraduate medical learners.Methods: This systematic narrative review was conducted according to the PRISMA guidelines. MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, ERIC and Google Scholar were searched. Full texts that applied to online videos, postgraduate medical learners and procedural skills were included without language restrictions. The methodological quality of the studies was evaluated using a validated tool. A thematic analysis of the studies was carried out using a general inductive approach.Results: A total of 785 articles were retrieved and the full text was reviewed for 66 articles that met the inclusion and exclusion criteria of the study. Twenty papers that were relevant to the role of online videos in postgraduate medical education of procedural skills were used for this review. They were heterogenous in the outcomes collected and the evidence was of variable quality. There was strong evidence for the use of online videos for procedural skill knowledge acquisition and retention. Online videos were used for various purposes, such as supervision, assessment, postoperative debriefing, providing feedback, and promoting reflection.Conclusion: Online videos are a valuable educational tool especially for procedural skill knowledge acquisition and retention. Future research needs to be carried out on the appropriate use of platforms in disseminating and using online videos, identifying the factors surrounding the learners, video characteristics, and data protection.
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Affiliation(s)
| | - Yan Chen
- Centre for Medical and Health Sciences Education, University of Auckland, Auckland, New Zealand
| | - Marcus A Henning
- Centre for Medical and Health Sciences Education, University of Auckland, Auckland, New Zealand
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van Munster KN, van Mil J, Safer R, Nieuwkerk PT, Ponsioen CY. Improving disease knowledge of primary sclerosing cholangitis patients and their relatives with a 3-dimensional education video. PATIENT EDUCATION AND COUNSELING 2020; 103:960-964. [PMID: 32005555 DOI: 10.1016/j.pec.2020.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Primary sclerosing cholangitis is a severe liver disease. Liver transplantation is the only curative therapeutic option. The unpredictable disease course causes much uncertainty and anxiety among patients and relatives. Improved disease knowledge may result in better health outcomes. In PSC, there is lack of high quality patient education materials. The aim of this study was to evaluate the ability of a 3-dimensional education video to improve PSC knowledge in patients and relatives. METHODS A digital survey containing questions about PSC, anxiety and satisfaction was sent prior to, directly after, and one week after watching the video. Both European and American patients and relatives were included. RESULTS A total of 278 participants (224 patients and 54 relatives) were included. PSC knowledge score increased from 53 % to 74 % directly after and 70 % one week after the video. The STAI anxiety score decreased after the video (-0,8, p = 0,007). Younger age and lower baseline knowledge were independent predictors of knowledge improvement. CONCLUSION Disease knowledge improved after watching the video and this was sustained one week later. Generally, patients were very enthusiastic about the video. PRACTICE IMPLICATIONS 3D education videos can be useful to increase disease knowledge in a severe disease such as PSC.
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Affiliation(s)
- K N van Munster
- Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, the Netherlands.
| | - J van Mil
- Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - R Safer
- Patient Organization PSC Partners Seeking a Cure, Greenwood Village, CO, USA
| | - P T Nieuwkerk
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - C Y Ponsioen
- Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, the Netherlands
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Zhao B, Lam J, Hollandsworth HM, Lee AM, Lopez NE, Abbadessa B, Eisenstein S, Cosman BC, Ramamoorthy SL, Parry LA. General surgery training in the era of robotic surgery: a qualitative analysis of perceptions from resident and attending surgeons. Surg Endosc 2020; 34:1712-1721. [PMID: 31286248 PMCID: PMC6946889 DOI: 10.1007/s00464-019-06954-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 06/26/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND The use of the surgical robot has increased annually since its introduction, especially in general surgery. Despite the tremendous increase in utilization, there are currently no validated curricula to train residents in robotic surgery, and the effects of robotic surgery on general surgery residency training are not well defined. In this study, we aim to explore the perceptions of resident and attending surgeons toward robotic surgery education in general surgery residency training. METHODS We performed a qualitative thematic analysis of in-person, one-on-one, semi-structured interviews with general surgery residents and attending surgeons at a large academic health system. Convenient and purposeful sampling was performed in order to ensure diverse demographics, experiences, and opinions were represented. Data were analyzed continuously, and interviews were conducted until thematic saturation was reached, which occurred after 20 residents and seven attendings. RESULTS All interviewees agreed that dual consoles are necessary to maximize the teaching potential of the robotic platform, and the importance of simulation and simulators in robotic surgery education is paramount. However, further work to ensure proper access to simulation resources for residents is necessary. While most recognize that bedside-assist skills are essential, most think its educational value plateaus quickly. Lastly, residents believe that earlier exposure to robotic surgery is necessary and that almost every case has a portion that is level-appropriate for residents to perform on the robot. CONCLUSIONS As robotic surgery transitions from novelty to ubiquity, the importance of effective general surgery robotic surgery training during residency is paramount. Through in-depth interviews, this study provides examples of effective educational tools and techniques, highlights the importance of simulation, and explores opinions regarding the role of the resident in robotic surgery education. We hope the insights gained from this study can be used to develop and/or refine robotic surgery curricula.
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Affiliation(s)
- Beiqun Zhao
- Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA.
| | - Jenny Lam
- Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA
| | - Hannah M Hollandsworth
- Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA
| | - Arielle M Lee
- Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA
| | - Nicole E Lopez
- Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA
| | - Benjamin Abbadessa
- Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA
| | - Samuel Eisenstein
- Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA
| | - Bard C Cosman
- Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA
| | - Sonia L Ramamoorthy
- Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA
| | - Lisa A Parry
- Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA
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Lee SA, Lee JM, Suh KS, Hong SK, Cho JH, Yi NJ, Lee KW. Wearable recording video technology for surgical training in living donor liver transplantation. Ann Hepatobiliary Pancreat Surg 2020; 24:38-43. [PMID: 32181427 PMCID: PMC7061037 DOI: 10.14701/ahbps.2020.24.1.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 10/07/2019] [Accepted: 10/08/2019] [Indexed: 12/04/2022] Open
Abstract
Backgrounds/Aims As the development of surgical video recording technologies, educational videos have become widely utilized for trainee education. However, the current forms of surgical video are limited because they do not show all the roles of the participants. Aim of this study is to make optimal training material about living donor liver transplantation for residents and fellows using wearable recording system. Methods Three video clips about procedure of liver transplantation were made. A head mount was used to fix the camera on the surgeon or assistant's head. Anastomosis of vessels, bench operation and trocar insertion for laparoscopic donor hepatectomy were recorded. Each video clips were edited including indicators, subtitles, and narration. The edited videos were shown to 20 General Surgery trainees (18 residents, 2 fellows) and we received feedback. The results of the questionnaire were quantitatively analyzed to show how efficient and informative it is compared to existing educational materials. Results Sixteen of the 20 trainees (80%) responded that this video helped them improve their surgical skills. Eighteen trainees (90%) responded that they gained new knowledge through this video. Sixteen trainees (80%) responded that the action camera image material was more educational than existing text-based and video-based materials, with an average score of 8.5 and 6.5 (action camera materials vs. text-based materials, respectively). Conclusions A head-mounted action camera video recording system is a good model for making high-quality educational video modules and can be a useful teaching tool for living donor liver transplantation.
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Affiliation(s)
- Shin Ae Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jeong-Moo Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Suk Suh
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Suk-Kyun Hong
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Hyung Cho
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Nam-Joon Yi
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kwang-Woong Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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Augestad KM, Butt K, Ignjatovic D, Keller DS, Kiran R. Video-based coaching in surgical education: a systematic review and meta-analysis. Surg Endosc 2019; 34:521-535. [PMID: 31748927 DOI: 10.1007/s00464-019-07265-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 11/12/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND In the era of competency-based surgical education, VBC has gained increased attention and may enhance the efficacy of surgical education. The objective of this systematic review was to summarize the existing evidence of video-based coaching (VBC) and compare VBC to traditional master-apprentice-based surgical education. METHODS We performed a systematic review and meta-analysis of randomized controlled trials (RCT) assessing VBC according to the PRISMA and Cochrane guidelines. The MEDLINE, EMBASE, and COCHRANE and Researchgate databases were searched for eligible manuscripts. Standard mean difference (SMD) of performance scoring scales was used to assess the effect of VBC versus traditional training without VBC (control). RESULTS Of 627 studies identified, 24 RCTs were eligible and evaluated. The studies included 778 surgical trainees (n = 386 VBC vs. n = 392 control). 13 performance scoring scales were used to assess technical competence; OSATS-GRS was the most common (n = 15). VBC was provided preoperative (n = 11), intraoperative (n = 1), postoperative (n = 10), and perioperative (n = 2). The majority of studies were unstructured, where identified coaching frameworks were PRACTICE (n = 1), GROW (n = 2) and Wisconsin Coaching Framework (n = 1). There was an effect on performance scoring scales in favor of VBC coaching (SMD 0.87, p < 0.001). In subgroup analyses, the residents had a larger relative effect (SMD 1.13; 0.61-1.65, p < 0.001) of VBC compared to medical students (SMD 0.43, 0.06-0.81, p < 0.001). The greatest source of potential bias was absence of blinding of the participants and personnel (n = 20). CONCLUSION Video-based coaching increases technical performance of medical students and surgical residents. There exist significant study and intervention heterogeneity that warrants further exploration, showing the need to structure and standardize video-based coaching tools.
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Affiliation(s)
- Knut Magne Augestad
- Department of Postgraduate Surgical Education, University Hospital North Norway, Tromsö, Norway. .,Department of GI Surgery, Sandnessjøen Regional Hospital, Sandnessjøen, Norway. .,Division of Colorectal Surgery, Columbia University Medical Center, New York, NY, USA.
| | - Khayam Butt
- Department of GI Surgery, Nordlandssykehuset, Bodø, Norway
| | - Dejan Ignjatovic
- Department of GI Surgery, Akershus University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Deborah S Keller
- Division of Colorectal Surgery, Columbia University Medical Center, New York, NY, USA
| | - Ravi Kiran
- Division of Colorectal Surgery, Columbia University Medical Center, New York, NY, USA
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Hadie SNH, Simok AA, Shamsuddin SA, Mohammad JA. Determining the impact of pre-lecture educational video on comprehension of a difficult gross anatomy lecture. J Taibah Univ Med Sci 2019; 14:395-401. [PMID: 31488974 PMCID: PMC6717076 DOI: 10.1016/j.jtumed.2019.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 06/15/2019] [Accepted: 06/19/2019] [Indexed: 11/01/2022] Open
Abstract
Objective Students commonly perceive gross anatomy lectures as difficult because they contain complex information that requires three-dimensional visualisation in order to be understood. Without prior preparation, a gross anatomy topic expounded via lecture can be cognitively challenging. Hence, this study aimed to investigate the impact of a pre-lecture activity in the form of viewing a video on students' lecture comprehension. Method A quasi-experimental study was conducted using 254 first-year medical students with no prior exposure to the lecture topic during the 2016/17 and 2017/18 academic sessions. The students from each batch were divided into two groups and exposed to different video material. Group A watched an action movie, while Group B watched an educational video related to the lecture topic. After 15 min, both groups attended a lecture on the gross anatomy of the heart, which was delivered by a qualified anatomist. At the end of the lecture, their understanding of the material was measured through a post-lecture test using ten vetted multiple choice true/false questions. Results Group B's test scores were found to be significantly higher than Group A's (p > 0.001, t-stats [df] = -4.21 [252]). Conclusion This study concluded that the pre-lecture activity had successfully provided the students with some prior knowledge of the subject before they attended the lecture sessions. This finding was aligned with cognitive load theory, which describes a reduction in learners' cognitive load when prior knowledge is stimulated.
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Affiliation(s)
- Siti N H Hadie
- Department of Anatomy, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Anna A Simok
- Department of Anatomy, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Shamsi A Shamsuddin
- Department of Anatomy, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Jamilah A Mohammad
- Department of Medical Education, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu, Kelantan, Malaysia
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Peahl AF, Tarr EE, Has P, Hampton BS. Impact of 4 Components of Instructional Design Video on Medical Student Medical Decision Making During the Inpatient Rounding Experience. JOURNAL OF SURGICAL EDUCATION 2019; 76:1286-1292. [PMID: 31056465 DOI: 10.1016/j.jsurg.2019.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/23/2019] [Accepted: 04/07/2019] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The Four Components of Instructional Design (4C-ID) Model has been used to teach Medical Decision Making (MDM), a core competency recognized by the Liaison Committee for Medical Education. 4 Components of Instructional Design (4C-ID) has been applied in general medical education, but not the inpatient clerkship setting. A 4C-ID video for inpatient rounding, like postpartum rounding in Ob/Gyn, could help improve MDM on busy services. METHODS Students in the third year Ob/Gyn clerkship were randomized by clerkship group to receive a 20-minute postpartum rounding video, based on 4C-ID principles, or usual teaching. MDM and knowledge were assessed pre-/postintervention with the Diagnostic Thinking Inventory and a case-based evaluation. Satisfaction was assessed with Likert style questions. RESULTS Seventy-eight students were randomized (36 control, 42 intervention). Both groups had equal baseline measures of MDM and knowledge, and similar postclerkship MDM. The intervention group demonstrated higher knowledge postclerkship (17.1, 22.6 p < 0.001). Students in the intervention felt prepared by the video, and would recommend it. Students in the control group reported higher satisfaction with their postpartum rounding experience (3.9, 3.5 p = 0.04). DISCUSSION Videos are easy to incorporate teaching platforms for medical students, however, the 4C-ID based video in this study did not increase student MDM. In addition, educators should use caution when integrating video into coursework as use of video may lead to decreased student satisfaction as it did in this study.
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Affiliation(s)
- Alex Friedman Peahl
- Department of Obstetrics and Gynecology, University of Michigan, Institute for Healthcare Policy and Innovation, National Clinical Scholar, Ann Arbor, Michigan.
| | - Elizabeth E Tarr
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Phinnara Has
- Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University/Women and Infants Hospital, Providence, Rhode Island
| | - B Star Hampton
- Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University/Women and Infants Hospital, Providence, Rhode Island
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Ghaderi I, Farrell TM. Toward effective feedback: From concept to practice. Surgery 2019; 167:685-688. [PMID: 31353077 DOI: 10.1016/j.surg.2019.06.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 05/27/2019] [Accepted: 06/17/2019] [Indexed: 11/17/2022]
Abstract
Feedback is the building block of assessment and an essential component of effective teaching. In this article, we will provide a comprehensive definition of feedback and a relevant conceptual framework for learning to explain how feedback can be used to improve performance. We will discuss the process of providing feedback, and the role teacher and learner can play to make it more effective. We will also examine the misunderstandings and pitfalls around feedback, as well as generational differences that may influence its impact.
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Affiliation(s)
- Iman Ghaderi
- Department of Surgery, University of Arizona, Tucson, AZ.
| | - Timothy M Farrell
- Department of Surgery, University of North Carolina at Chapel Hill, NC
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What Is a Good Teaching Video? Results of an Online International Survey. J Minim Invasive Gynecol 2019; 27:738-747. [PMID: 31233782 DOI: 10.1016/j.jmig.2019.05.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 05/18/2019] [Accepted: 05/22/2019] [Indexed: 11/27/2022]
Abstract
STUDY OBJECTIVE To analyze surgeon views on criteria for a good teaching video with the aim of determining guidelines. DESIGN An online international survey using a self-developed questionnaire. SETTING A French university tertiary care hospital. PATIENTS Three hundred eighty-eight participants answered an online questionnaire (154 women [40.53%] and 226 men [59.47%]). INTERVENTIONS A questionnaire on the criteria for a good quality teaching surgery video was developed by our team and communicated via an online link. MEASUREMENTS AND MAIN RESULTS The responses of 388 respondents were analyzed and highlighted the pedagogical benefits of teaching videos. The video duration may vary according to the type of media or surgical procedure but should not exceed 10 to 15 minutes for complex procedures. Providing information on the surgical setup (body mass index of the patient, Trendelenburg position degree, pressure of pneumoperitoneum, etc.) is essential. Surgical videos should be reviewed and divided into clearly defined steps with continued access to the entire nonmodified video for reviewers and be accessible on both educational and open platforms. Patient consent and relevant information should be made available. Reviews should include "bad procedure" videos, which are highly appreciated, especially by young surgeons. CONCLUSION The many advantages of the video format, including availability and rising popularity, provide an opportunity to reinforce and complement current surgical teaching. To optimize use of this surgical teaching tool, standardization, updating, and ease of access of surgical videos should be promoted.
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Wu JC, Chi SC, Wu CC, Kang YN. Helps from flipped classroom in learning suturing skill: The medical students' perspective. PLoS One 2018; 13:e0204698. [PMID: 30278060 PMCID: PMC6168146 DOI: 10.1371/journal.pone.0204698] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 09/12/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Today, flipped classroom (FC) has been widely used in medical education. However, the effectiveness of FC remains controversial. The variation may cause by different subjects or different course design. Moreover, those studies did not explain how the association among different domains of learning objective was in FCs. The purpose of this study was to explore the help of learning domains from a FC of suturing skill in year-5 medical students. DESIGN This study determined sample size according to statistical power. A minimum number of 77 participants for regression analysis are needed. Therefore, this study enrolled 78 medical students in a 2-hour suturing course, which consisted of pre-class video and in-class instruction. Both simple and mattress suturing were taught. The students received an anonymous survey with questionnaire of Help from Instruction Questionnaire for Clinical Skills (HIQ-CS) after the course. The HIQ-CS was developed by medical education team according to Bloom's taxonomy, and its reliability was favorable (Cronbach's ^l = 0.839). Factor loadings among all items in the HIQ-CS was also favorable (0.790 to 0.849). This study determined consensus of students' perspective by median (Me) and interquartile range (IQR), and tested mediation among different learning domains by regression. RESULTS The results showed medical students agreed FC can help them in learning suturing (Me = 4, IQR = 1). The cognitive help (β = .526, p < .001) was completely mediated by psychomotor help (β = .399, p < .001) and affective help (β = .413, p < .001) to overall helps in FC. The affective help (β = .617, p < .001) was partially mediated by psychomotor help to overall helps in FC. CONCLUSIONS FC may help students in learning suturing skill in different domains. Our model explains the cognitive help from FC provides an important foundation for the helps of other domains. Although the model should be examined by different curricula and measurements in future, the model of help from instruction in our study provided an innovated concept and framework in medical education.
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Affiliation(s)
- Jen-Chieh Wu
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, R.O.C. (Taiwan)
- Department of Education, Taipei Medical University Hospital, Taipei, R.O.C. (Taiwan)
| | - Sheng-Chu Chi
- Department of Education, Taipei Medical University Hospital, Taipei, R.O.C. (Taiwan)
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, R.O.C. (Taiwan)
| | - Chien-Chih Wu
- Department of Education, Taipei Medical University Hospital, Taipei, R.O.C. (Taiwan)
- Department of Medical Education and Humanities, School of Medicine, College of Medicine, Taipei Medical University, Taipei, R.O.C. (Taiwan)
- Department of Urology, Taipei Medical University Hospital, Taipei, R.O.C. (Taiwan)
| | - Yi-No Kang
- Department of Education, Taipei Medical University Hospital, Taipei, R.O.C. (Taiwan)
- Department of Medical Education and Humanities, School of Medicine, College of Medicine, Taipei Medical University, Taipei, R.O.C. (Taiwan)
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