The Art of Teaching, Training, and Putting the Scalpel in Residents' Hands

The use of metaverse in medical education: A systematic review

OBJECTIVE

This study aims to systematically evaluate the influence of metaverse-based teaching tools on the medical teaching effect and the improvement of students' ability, providing evidence-based support for curriculum development.

METHODS

A comprehensive search of PubMed, Cochrane, Embase, and Web of Science databases was conducted up to March 9, 2025. Two researchers independently screened articles, extracted data, and assessed bias using the Cochrane Handbook 5.1.0 checklist. Data analysis was performed using RevMan 5.3.

RESULTS

Thirty studies involving 1,560 participants. The metaverse was applied in various areas such as surgery training, anatomy teaching, and communication skills. Common metaverse approaches include AR, VR, MR, etc., with simulated teaching times ranging from as little as 10 minutes to lasting several weeks. Most studies reported improved student guidance, reduced training time, and enhanced learning interest, and confidence.

CONCLUSION

Metaverse technology proves effective for medical teaching, offering theoretical support for further research.

Teaching residents in emergency surgery for acute bowel obstruction-is supervised surgery safe and feasible? A retrospective single-center analysis from a MIS-specialized hospital

OBJECTIVE

Emergency surgery for acute bowel obstruction (ABO) is a common and occasionally technically demanding procedure, requiring both surgical skill and strategic planning. The risk entailed in teaching residents during ABO surgery has not been defined or investigated in detail to date. It is the aim of this study to reveal whether surgery for ABO, performed by resident surgeons under supervision, is safe and feasible.

DESIGN

A retrospective analysis was conducted of all emergency surgeries for ABO performed between 2009 and 2023 at a community-based hospital. Patients' general characteristics, procedural data and outcome parameters were compared. Differences between teaching procedures and non-teaching procedures were analysed.

SETTING

The study was conducted at the Department of General and Visceral surgery at a community-based hospital (St. John of God Hospital Salzburg, Austria).

PARTICIPANTS

All emergency surgeries for ABO (n = 300 patients) that were performed during the study period were included.

RESULTS

Emergency surgery for ABO was performed in 300 patients during the study period, 15.3% of which operations were performed by residents under supervision and 84.7% by senior surgeons. No differences between these two groups were found in terms of patient characteristics, except for a past medical history of previous gynecologic or urologic surgery that was more frequent in the senior surgeon group (p = 0.02). Neither procedural data nor conversion rates from a minimally invasive (MIS) to an open (OS) approach, nor postoperative complication rates were found to be significantly different between these groups.

CONCLUSION

Emergency surgery for ABO, performed by residents under supervision, is safe and feasible, showing no significant differences in terms of complication rates, morbidity or mortality as compared to procedures performed by senior surgeons.

Assessment of complications in third molar surgery performed by resident surgeons: A comprehensive analysis

Introduction

Third molar extractions present a wide spectrum of reported complications, spanning from 2.6 % to 30.9 %, making it challenging to predict outcomes for individual patients.This study seeks to evaluate third molar extractions conducted exclusively by stomatology or maxillofacial surgery residents, examining associated complications. Its aim also extends to delineating the related risks concerning epidemiological and clinical factors, juxtaposed against findings in the existing literature.

Materials and methods

An observational prospective cohort study was conducted at the Clinical and Academic Centre of Coimbra, Portugal, from July 2021 to December 2023. Descriptive statistics were used considering the adequate statistical parameters. Inferential statistical analysis was performed using Student's t-test, the Chi-squared test, and Spearman rank correlation to analyze the relationship between study variables. A p-value of less than 0.05 was considered statistically significant.

Results

485 patients underwent third molar extractions performed exclusively by stomatology and maxillofacial surgery residents, comprising a total of 686 extracted teeth and resulting in 71 reported complications (14.6 % per patient and 10.3 % per extracted tooth). Results revealed that patients undergoing lower third molar extraction faced a 3.7 times higher risk of complications compared to those undergoing upper third molar extraction. Teeth categorized as "IIIC" by Pell and Gregory's classification and those undergoing osteotomy and odontosection also exhibited a higher-than-expected complication rate with statistically significant differences being observed. No other variables showed a positive or negative statistically significant correlation with complication occurrence.

Discussion and conclusion

Despite the expectation of a heightened complication rate, this study revealed that a successful and comprehensive training regimen results in encountering complication rates akin to those documented in established literature.These findings also underscore the importance of recognizing that a resident's surgical accomplishment is intrinsically tied to acknowledging and respecting their learning curve.

Commentary on "supervisory knowing in practice across medical specialties" : Scalpel, please! Why is it more challenging to hand over the scalpel than a ward round for future surgeons' learning?

In the dynamic, non-linear world of medical education, balancing patient care and trainee learning is a complex task. This commentary responds to the original article by Noble et al. (2023), which challenges the perceived tension between patient care and trainee learning in the surgical environment and advocates for their co-occurrence across various medical specialties. The article explores supervisory practices across disciplines and proposes a holistic reconceptualization of clinical supervision in surgery. From various perspectives, the importance of hands-on opportunities in the operation theatre and the challenges trainees encounter in gaining practical experience are emphasized. Strategies aimed at improving clinical supervision and enhancing surgical education are suggested. By addressing these challenges and providing more opportunities for hands-on training across specialties, surgical education programs can better prepare trainees for the demands of their future careers while ensuring high-quality patient care.

Intraoperative teaching methods, models, and frameworks: A scoping review for surgical resident education

BACKGROUND

This review aimed to consolidate the existing literature on intraoperative teaching strategies and highlight areas for future research.

OBJECTIVE

The objective is to review the research conducted regarding the implementation of various teaching frameworks for surgical learners and to present their feasibility, benefits, and limitations within surgical residencies, as well as areas for future research.

METHODS

Two independent investigators searched MEDLINE, EMBASE, and ERIC and reviewed articles on intraoperative teaching strategies for surgical resident education.

RESULTS

3050 abstracts were reviewed, and 66 studies (2.2%) were included. The most common study type was single cohort studies (33%), followed by survey studies (17%). The majority of articles were carried out in General Surgery (50%), or a combination of surgical specialties (17%).

CONCLUSIONS

The BID model encompasses perioperative teaching time points and suggests a universal organizational approach to intraoperative teaching that would likely be compatible with documented competency assessments for residents.

Does Training Background Influence Outcomes after Coronal Scalp Incision for Treating Craniomaxillofacial Injuries?: A German Pilot Study

Objectives

To examine outcomes of the coronal scalp approach to craniomaxillofacial (CMF) fractures performed by oral-maxillofacial or craniofacial plastic surgery residents (OMFS/CFPS-Rs) vs. trauma surgery residents (TS-Rs), and to determine differences in treatment outcomes between both operator groups.

Methods

This retrospective cohort study enrolled a sample of CMF fracture adult patients treated via the coronal approach in a German level one trauma center during a two-year interval. The predictor variable was training background (OMFS/CFPS-Rs vs. TS-Rs; each n = 5). All trainees must assist in ≥ two surgeries before self-performance. The main outcomes were length of hospital stay (LHS) and coronal flap-related complications (CFRCs). Appropriate statistics were computed at α = 95%.

Results

Of the 97 patients identified during the study period; 71 of whom (19.7% females; mean age, 40.2 ± 15.2 years; 46.5% operated by TS-Rs; 38% combined upper and midfacial fractures) met the inclusion criteria. Operative time, LHS, CFRCs, readmission rates, and post-discharge emergency room visits were not significantly different between the trainee groups. 60% of CFRCs were visible/unfavorable or hypertrophic scar with/without alopecia. The number needed to treat of short LHS was 44 (95% confidence interval [CI], 3.9 to 4.8), the number needed to harm of CFRCs was 14 (95% CI, 3.6 to 7.4), i.e., the likelihood to be helped or harmed was 0.32.

Conclusions

Coronal flap raising by OMFS/CFPS-Rs does not appear beneficial over that by TS-Rs in terms of LHS and CFRCs evaluated until postoperative month six. Trainees from any surgical specialties could gain partial independence from skilled surgeons in CMF trauma “sub-steps” and favorable clinical outcomes. Further studies in a larger sample cohort are required to confirm this pilot data.

Supervision and Assistance Based on Mobile Information System in Art Video Teaching

To enrich students' learning methods, improve their interest in learning, and enable students to fully understand and master the content of art video teaching, a supervision and assistance function based on mobile information system in art video teaching is proposed. Starting with the purpose of improving the auxiliary effect of art video teaching, this study deeply discusses the construction of personalized art video mobile information teaching system based on mobile information technologies such as self-media auxiliary technology and computer-aided technology. Therefore, this study takes android technology mobile information system as a breakthrough to design the video teaching system and introduces the design of mobile teaching information platform in detail. At the same time, according to the relevant requirements of art video teaching, this study designs the teaching system from the aspects of improving students' learning interest, promoting students' curriculum preference information, efficient real-time teacher-student interaction, and so on. According to the requirements of the six sections, the function of the teaching supervision and management module is improved. Through the test of result extraction and data analysis, the feasibility of the user preference extraction and analysis algorithm and the content similarity discrimination algorithm is finally verified. The results show that after more than 10 times of reading, the graphics of video teaching content can basically solve the problem of comparative similarity of the same type of teaching content. At the same time, after more than 30 times of reading, the teaching content can basically solve the problem of small probability error of user system.