Application of technology to educational needs in surgery

Impact of Preoperative Warm-Up on Surgical Performance of Resident Physicians: A Randomized Controlled Trial

INTRODUCTION

Surgical learning is a complex process that involves resident characteristics, instructional methods, and technological tools. As surgical residency programs become more diverse, there is a growing need for adaptable training methods that align with various learning styles and backgrounds. Manual dexterity and self-assessment skills are essential for residents, and recent studies highlight those residents with refined manual skills perform better in surgery. Preoperative warm-up is emerging as a potential strategy to improve immediate surgical performance. The study aimed to analyze whether preoperative warm-up in low-cost surgical simulators (training boxes) is related to an immediate improvement in the intraoperative performance of general surgery residents inexperienced in laparoscopy.

METHODS

The study used a swine model for surgical simulations in a controlled training environment. 105 first-year general surgery residents were divided into 2 groups: the control group (performed procedures without warm-up) and the intervention group (performed a 10-minute preoperative warm-up using a training box).

RESULTS

The Intervention group demonstrated improved efficiency in cholecystectomy (2.97 ± 0.4 vs 2.41 ± 0.91, p = 0.03), with reductions of 41.5% in cholecystectomy dissection time (4.82 ± 4.94 vs 8.23 ± 5.15 minutes, p = 0.02) and 15.6% in left radical nephrectomy dissection time (13.03 ± 4.49 vs 16.77 ± 3.90 minutes, p = 0.012).

CONCLUSIONS

Preoperative warm-up using a training box significantly improved the qualitative and quantitative surgical performance of general surgery residents with no prior laparoscopic experience, particularly by increasing efficiency in cholecystectomy and reducing dissection times in both cholecystectomy and left radical nephrectomy.

Impact of artificial intelligence on the training of general surgeons of the future: a scoping review of the advances and challenges

PURPOSE

To explore artificial intelligence's impact on surgical education, highlighting its advantages and challenges.

METHODS

A comprehensive search across databases such as PubMed, Scopus, Scientific Electronic Library Online (SciELO), Embase, Web of Science, and Google Scholar was conducted to compile relevant studies.

RESULTS

Artificial intelligence offers several advantages in surgical training. It enables highly realistic simulation environments for the safe practice of complex procedures. Artificial intelligence provides personalized real-time feedback, improving trainees' skills. It efficiently processes clinical data, enhancing diagnostics and surgical planning. Artificial intelligence-assisted surgeries promise precision and minimally invasive procedures. Challenges include data security, resistance to artificial intelligence adoption, and ethical considerations.

CONCLUSIONS

Stricter policies and regulatory compliance are needed for data privacy. Addressing surgeons' and educators' reluctance to embrace artificial intelligence is crucial. Integrating artificial intelligence into curricula and providing ongoing training are vital. Ethical, bioethical, and legal aspects surrounding artificial intelligence demand attention. Establishing clear ethical guidelines, ensuring transparency, and implementing supervision and accountability are essential. As artificial intelligence evolves in surgical training, research and development remain crucial. Future studies should explore artificial intelligence-driven personalized training and monitor ethical and legal regulations. In summary, artificial intelligence is shaping the future of general surgeons, offering advanced simulations, personalized feedback, and improved patient care. However, addressing data security, adoption resistance, and ethical concerns is vital. Adapting curricula and providing continuous training are essential to maximize artificial intelligence's potential, promoting ethical and safe surgery.

Reviewing the current state of virtual reality integration in medical education - a scoping review

BACKGROUND

In medical education, new technologies like Virtual Reality (VR) are increasingly integrated to enhance digital learning. Originally used to train surgical procedures, now use cases also cover emergency scenarios and non-technical skills like clinical decision-making. This scoping review aims to provide an overview of VR in medical education, including requirements, advantages, disadvantages, as well as evaluation methods and respective study results to establish a foundation for future VR integration into medical curricula.

METHODS

This review follows the updated JBI methodology for scoping reviews and adheres to the respective PRISMA extension. We included reviews in English or German language from 2012 to March 2022 that examine the use of VR in education for medical and nursing students, registered nurses, and qualified physicians. Data extraction focused on medical specialties, subjects, curricula, technical/didactic requirements, evaluation methods and study outcomes as well as advantages and disadvantages of VR.

RESULTS

A total of 763 records were identified. After eligibility assessment, 69 studies were included. Nearly half of them were published between 2021 and 2022, predominantly from high-income countries. Most reviews focused on surgical training in laparoscopic and minimally invasive procedures (43.5%) and included studies with qualified physicians as participants (43.5%). Technical, didactic and organisational requirements were highlighted and evaluations covering performance time and quality, skills acquisition and validity, often showed positive outcomes. Accessibility, repeatability, cost-effectiveness, and improved skill development were reported as advantages, while financial challenges, technical limitations, lack of scientific evidence, and potential user discomfort were cited as disadvantages.

DISCUSSION

Despite a high potential of VR in medical education, there are mandatory requirements for its integration into medical curricula addressing challenges related to finances, technical limitations, and didactic aspects. The reported lack of standardised and validated guidelines for evaluating VR training must be overcome to enable high-quality evidence for VR usage in medical education. Interdisciplinary teams of software developers, AI experts, designers, medical didactics experts and end users are required to design useful VR courses. Technical issues and compromised realism can be mitigated by further technological advancements.