Learning from the surgeon's real perspective - First-person view versus laparoscopic view in e-learning for training of surgical skills? Study protocol for a randomized controlled trial

Designing an E-learning Readiness Assessment Model for Iraqi Universities Employing Fuzzy Delphi Method

The assessment process of readiness for adoption an educational system considers the lifeblood of the e-learning system in a particular educational organization and the ability to assess the organization's readiness among the main factors which contributes to the success and progress. The readiness models are instruments that assist educational organizations in measuring their capability level and identifying the gaps to develop a strategy for implementing and adopting e-learning system. Due to the sudden chaos that Iraqi educational institutions have been exposed to the Covid-19 epidemic since the beginning of 2020, the e-learning system has been adopted as a quick alternative educational system for the continuation of the educational process without taking into consideration the readiness of the basic components of the educational process, which comprises the readiness of the infrastructure, human and educational organization to adopt such systems. Despite increased attention by stakeholders and the government with the readiness assessment process recently, there is no comprehensive model for assessing e-learning readiness in Iraqi higher education institutions, the purpose of this study is to design a model of an e-learning readiness assessment for Iraqi universities based on the comparative studies and the experts' views. It is worth to mention that the proposed model has objectively designed according to particular features and local characteristics country. The fuzzy delphi method was utilized for the validation process of the proposed model. The main dimensions and all factors of the proposed model reached the experts' agreement except a number of measures that did not achieve the assessment requirements. The final analysis result indicates that the e-learning readiness assessment model includes 3 main dimensions and 13 factors with 86 measures. Iraqi higher educational institutions can employ the designed model to assess their readiness and identify the areas that need improvement and reduce the gaps failures in e-learning adoption.

Gamification in E-Learning and Sustainability: A Theoretical Framework

Progress in communication technologies and social isolation caused by the COVID-19 pandemic have supported the acceptance of e-learning. In the e-learning context, gamification has been identified as one of the most promising trends. Many researchers believe in the game elements’ capacity to drive learning, skills acquisition, and changes for more sustainable behavior. However, the literature on the subject is dispersed, addressing behavioral attitudes and elements in an isolated and fragmented way. This study aims to present a framework relating game elements to behavioral attitudes to promote sustainability and ensure quality of learning. The methodology is based on a systematic literature review using the PRISMA protocol, covering the content analysis of 130 articles indexed in the Web of Science database. For the framework construction, the following were identified: behavioral attitudes stimulated by gamification; main game elements and how they relate to each other. Based on this, a framework called 7GOALS (Gamification-Oriented Active Learning Steps) associated with the PDCA (Plan, Do, Check, Act) was established. The proposed structure is multidisciplinary and can be used in any knowledge field that uses gamification. With this, themes such as sustainability can be widely disseminated and leverage changes towards more sustainable behaviors that adhere to the real world.

Application of multidirectional stitching technology in a laparoscopic suturing instructional program: a randomized controlled trial

BACKGROUND

Surgeon suturing technology plays a pivotal role in patient recovery after laparoscopic surgery. Intracorporal suturing and knot tying in minimally invasive surgery are particularly challenging and represent a key skill for advanced procedures. In this study, we compared the application of multidirectional stitching technology with application of the traditional method in a laparoscopic suturing instructional program.

METHODS

We selected forty residents within two years of graduation to assess the specialized teaching of laparoscopic suturing with laparoscopic simulators. The forty students were randomly divided into two groups, a control group and an experimental group, with twenty students in each group. The control group was scheduled to learn the traditional suture method, and the experimental group applied multidirectional stitching technology. The grades for suturing time, thread length, accuracy of needle entry, stability of the knot, tissue integrity, and tightness of the tissue before and after the training program were calculated.

RESULTS

There was no significant difference between the two groups before the learning intervention. After the program, both groups significantly improved in each subject. There were significant differences between the control group and the experimental group in suture time (P = 0.001), accuracy of needle entry and exit (P = 0.035), and whether the suture tissue had cracks (P = 0.030). However, the two groups showed non-significant differences in thread length (P = 0.093), stablity of the knot (P = 0.241), or tightness of the tissue (P = 0.367).

CONCLUSIONS

Multidirectional stitching technology improves the efficiency and effectiveness of traditional laparoscopic suture instructional programs. It might be a practicable, novel training method for acquiring proficiency in manual laparoscopic skills in a training setting.

Self-directed training with e-learning using the first-person perspective for laparoscopic suturing and knot tying: a randomised controlled trial : Learning from the surgeon's real perspective

BACKGROUND

Laparoscopic suturing and knot tying is essential for advanced laparoscopic procedures and requires training outside of the operating room. However, personal instruction by experienced surgeons is limitedly available. To address this, the concept of combining e-learning with practical training has become of interest. This study aims to investigate the influence of the first-person perspective in instructional videos, as well as the feasibility of a completely self-directed training curriculum for laparoscopic suturing and knot tying.

MATERIALS AND METHODS

Ninety-one laparoscopically naïve medical students were randomised into two groups training with e-learning videos in either the first-person perspective (combining endoscopic view and view of hands/instruments/forearm motion) or the endoscopic view only. Both groups trained laparoscopic suturing and knot tying in teams of two until reaching predefined proficiency levels. Blinded, trained raters regularly assessed the participants' performance by using validated checklists. After training, participants filled out questionnaires regarding training experience and personal characteristics.

RESULTS

Average training time to reach proficiency did not differ between groups [first-person perspective (min): 112 ± 44; endoscopic view only (min): 109 ± 47; p = 0.746]. However, participants from both groups perceived the first-person perspective as useful for learning new laparoscopic skills. Both groups showed similar baseline performances and improved significantly after training [Objective Structured Assessment of Technical Skills (OSATS) (max. 37 points): first-person perspective: 30.3 ± 2.3; endoscopic view only: 30.8 ± 2.3]. All participants managed to reach proficiency, needing 8-43 attempts without differences between groups. Visuospatial abilities (mental rotation) seemed to enhance the learning curve.

CONCLUSION

Modifying instructional videos to the first-person perspective did not translate into a better performance in this setting but was welcomed by participants. Completely self-directed training with the use of e-learning can be a feasible training approach to achieve technical proficiency in laparoscopic suturing and knot tying in a training setting.