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Cairo F, Burkhardt R. Minimal invasiveness in gingival augmentation and root coverage procedures. Periodontol 2000 2023; 91:45-64. [PMID: 36694255 DOI: 10.1111/prd.12477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/30/2022] [Accepted: 07/20/2022] [Indexed: 01/26/2023]
Abstract
Minimally invasive surgical procedures aim at optimal wound healing, a reduction of postoperative morbidity and, thus, at increased patient satisfaction. The present article reviews the concept of minimal invasiveness in gingival augmentation and root coverage procedures, and critically discusses the influencing factors, technical and nontechnical ones, and relates them to the underlying biological mechanisms. Furthermore, the corresponding outcomes of the respective procedures are assessed and evaluated in relation to a possible impact of a minimized surgical invasiveness on the clinical, aesthetic, and patient-related results.
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Affiliation(s)
- Francesco Cairo
- Head Research Unit in Periodontology and Periodontal Medicine, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Rino Burkhardt
- Private Practice, Zurich, Switzerland.,Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Prince Philip Dental Hospital, The University of Hong Kong, Hong Kong, Hong Kong, SAR.,Department of Periodontics & Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
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2
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Lavoie P, Lapierre A, Maheu-Cadotte MA, Fontaine G, Khetir I, Bélisle M. Transfer of Clinical Decision-Making-Related Learning Outcomes Following Simulation-Based Education in Nursing and Medicine: A Scoping Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:738-746. [PMID: 34789663 DOI: 10.1097/acm.0000000000004522] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE Simulation is often depicted as an effective tool for clinical decision-making education. Yet, there is a paucity of data regarding transfer of learning related to clinical decision-making following simulation-based education. The authors conducted a scoping review to map the literature regarding transfer of clinical decision-making learning outcomes following simulation-based education in nursing or medicine. METHOD Based on the Joanna Briggs Institute methodology, the authors searched 5 databases (CINAHL, ERIC, MEDLINE, PsycINFO, and Web of Science) in May 2020 for quantitative studies in which the clinical decision-making performance of nursing and medical students or professionals was assessed following simulation-based education. Data items were extracted and coded. Codes were organized and hierarchized into patterns to describe conceptualizations and conditions of transfer, as well as learning outcomes related to clinical decision-making and assessment methods. RESULTS From 5,969 unique records, 61 articles were included. Only 7 studies (11%) assessed transfer to clinical practice. In the remaining 54 studies (89%), transfer was exclusively assessed in simulations that often included one or more variations in simulation features (e.g., scenarios, modalities, duration, and learner roles; 50, 82%). Learners' clinical decision-making, including data gathering, cue recognition, diagnoses, and/or management of clinical issues, was assessed using checklists, rubrics, and/or nontechnical skills ratings. CONCLUSIONS Research on simulation-based education has focused disproportionately on the transfer of learning from one simulation to another, and little evidence exists regarding transfer to clinical practice. The heterogeneity in conditions of transfer observed represents a substantial challenge in evaluating the effect of simulation-based education. The findings suggest that 3 dimensions of clinical decision-making performance are amenable to assessment-execution, accuracy, and speed-and that simulation-based learning related to clinical decision-making is predominantly understood as a gain in generalizable skills that can be easily applied from one context to another.
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Affiliation(s)
- Patrick Lavoie
- P. Lavoie is assistant professor, Faculty of Nursing, Université de Montréal, and researcher, Montreal Heart Institute, Montreal, Quebec, Canada; ORCID: https://orcid.org/0000-0001-8244-6484
| | - Alexandra Lapierre
- A. Lapierre is a doctoral candidate, Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada; ORCID: https://orcid.org/0000-0002-8704-4940
| | - Marc-André Maheu-Cadotte
- M.-A. Maheu-Cadotte is a doctoral candidate, Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada; ORCID: https://orcid.org/0000-0003-3190-0901
| | - Guillaume Fontaine
- G. Fontaine is a postdoctoral research fellow, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; ORCID: https://orcid.org/0000-0002-7806-814X
| | - Imène Khetir
- I. Khetir is a master's student, Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
| | - Marilou Bélisle
- M. Bélisle is associate professor, Faculty of Education, Université de Sherbrooke, Longueuil, Quebec, Canada
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Yao S, Tang Y, Yi C, Xiao Y. Research Hotspots and Trend Exploration on the Clinical Translational Outcome of Simulation-Based Medical Education: A 10-Year Scientific Bibliometric Analysis From 2011 to 2021. Front Med (Lausanne) 2022; 8:801277. [PMID: 35198570 PMCID: PMC8860229 DOI: 10.3389/fmed.2021.801277] [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: 10/25/2021] [Accepted: 12/27/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In recent decades, an increasing number of studies have focused on the clinical translational effect of simulation-based medical education (SBME). However, few scientific bibliometric studies have analyzed the research hotspots and publication trends. This study aimed to investigate research hotspots and future direction in the clinical translational outcome of SBME via bibliometrics. METHOD Relevant publications on the clinical translational outcomes of SBME from 2011 to 2021 were identified and retrieved from the Web of Science Core Collection (WOSCC). Software including VOSviewer (1.6.17) and CiteSpace (5.8R3) and a platform (bibliometric.com) were employed to conduct bibliographic and visualized analysis on the literature. RESULTS A total of 1,178 publications were enrolled. An increasing number of publications were observed in the past decades from 48 in 2011 to 175 in 2021. The United States accounted for the largest number of publications (488, 41.4%) and citations (10,432); the University of Toronto and Northwestern University were the leading institutions. Academic Medicine was the most productive journal concerning this field. McGaghie W C and Konge L were the most influential authors in this area. The hot topic of the translational outcome of SBME was divided into 3 stages, laboratory phase, individual skill improvement, and patient outcome involving both technical skills and non-technical skills. Translational research of comprehensive impact and collateral outcomes could be obtained in the future. CONCLUSION From the overall trend of 10 years of research, we can see that the research is roughly divided into three phases, from laboratory stage, individual skill improvement to the patient outcomes, and comprehensive impacts such as skill retention and collateral effect as cost-effectiveness is a major trend of future research. More objective evaluation measurement should be designed to assess the diverse impact and further meta-analysis and randomized controlled trials are needed to provide more clinical evidence of SBME as translational science.
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Affiliation(s)
- Shun Yao
- Clinical Skills Training Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yabin Tang
- Clinical Skills Training Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Chenyue Yi
- Clinical Skills Training Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yao Xiao
- Clinical Skills Training Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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Current status of simulation-based training tools in general surgery: A systematic review. INTERNATIONAL JOURNAL OF SURGERY OPEN 2022. [DOI: 10.1016/j.ijso.2021.100427] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Garbee DD, Bonanno LS, Rogers CL, Kerdolff KE, Paige JT. Comprehensive Literature Search to Identify Assessment Tools for Operating Room Nontechnical Skills to Determine Common Critical Components. MEDICAL SCIENCE EDUCATOR 2021; 31:81-89. [PMID: 34457868 PMCID: PMC8368576 DOI: 10.1007/s40670-020-01117-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/12/2020] [Indexed: 06/13/2023]
Abstract
BACKGROUND Effective use of nontechnical skills (NTS) contributes to the provision of safe, quality care in the fast-paced, dynamic setting of the operating room (OR). Inter-professional education of NTS to OR team members can improve performance. Such training requires the accurate measurement of NTS in order to identify gaps in their utilization by OR teams. Although several instruments for measuring OR NTS exist in the literature, each tool tends to define specific NTS differently. AIM We aimed to determine commonalities in defined measurements among existing OR NTS tools. METHODS We undertook a comprehensive literature review of assessment tools for OR NTS to determine the critical components common to these instruments. A PubMed search of the literature from May 2009 to May 2019 combined various combinations of keywords and Medical Subject Headings (MeSH) related to the following subjects: teamwork, teams, assessment, debriefing, surgery, operating room, nontechnical, communication. From this start, articles were selected describing specific instruments. Three reviewers then identified the common components measured among these assessment tools. Reviewers collated kin constructs within each instrument using frequency counts of similarly termed and conceptualized components. RESULTS The initial PubMed search produced 119 articles of which 24 articles satisfied the inclusion criteria. Within these articles, 10 assessment tools evaluated OR NTS. Kin constructs were grouped into six NTS categories in the following decreasing frequency order: communication, situation awareness, teamwork, leadership, decision making, and task management/decision making (equal). CONCLUSION NTS OR assessment tools in the literature have a variety of kin constructs related to the specific measured components within the instruments. Such kin constructs contain thematic cohesion across six primary NTS groupings with some variation in scale and scope. Future plans include using this information to develop an easy-to-use assessment tool to assist with debriefing in the clinical environment.
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Affiliation(s)
- Deborah D. Garbee
- School of Nursing, LSU Health New Orleans Health Sciences Center, 1900 Gravier Street, New Orleans, LA 70112 USA
| | - Laura S. Bonanno
- School of Nursing, LSU Health New Orleans Health Sciences Center, 1900 Gravier Street, New Orleans, LA 70112 USA
| | - Camille L. Rogers
- Department of Surgery, LSU Health New Orleans Health Sciences Center, 1542 Tulane Avenue, Room 734, New Orleans, LA 70112 USA
| | - Kathryn E. Kerdolff
- John P. Ische Library, LSU Health New Orleans Health Sciences Center, 533 Bolivar Street, New Orleans, LA 70112 USA
| | - John T. Paige
- Department of Surgery, LSU Health New Orleans Health Sciences Center, 1542 Tulane Avenue, Room 734, New Orleans, LA 70112 USA
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Stainman RS, Lewis A, Nelson A, Zabar S, Kurzweil AM. Training in Neurology: Identifying and addressing struggling colleagues in the era of physician burnout. Neurology 2020; 95:796-799. [DOI: 10.1212/wnl.0000000000010601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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7
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Hurley J, Hutchinson M, Kozlowski D, Gadd M, van Vorst S. Emotional intelligence as a mechanism to build resilience and non-technical skills in undergraduate nurses undertaking clinical placement. Int J Ment Health Nurs 2020; 29:47-55. [PMID: 31127972 DOI: 10.1111/inm.12607] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/06/2019] [Indexed: 11/28/2022]
Abstract
The environments in which nursing work is undertaken can be highly stressful and complex with resultant harmful outcomes for the health of both nurses and patients reported. Undergraduate nursing students are particularly challenged when on clinical placement through having only partially developed work capabilities, with wide claims that these nurses remain underprepared for work even upon graduation. Over time undergraduate nursing education has arguably not prioritized developing resilience and other non-technical skills required to respond effectively to these challenges. This paper reports findings from a qualitative study of student nurses who received training and coaching in emotional intelligence, a well-established correlate of resilience, just prior to undertaking a mental health or medical/surgical clinical placement. Of that cohort, 12 agreed to qualitative semi-structured interviews that sought to better understand how these students used the knowledge and capabilities from the training within clinical placement contexts. Four themes emerged from the thematic analysis of the interviews: (1) greater experiences of resilience; (2) responding positively to mental health consumers; (3) experiences of greater empathy and compassion; and (4) experiences of improved non-technical work skills. Implications from these findings suggest that student and patient experiences of nursing placement, and mental health nursing placements in particular, would be enhanced by pre-placement emotional intelligence training and coaching. Such training will support nursing graduates to be work-ready upon entering the workforce.
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Affiliation(s)
- John Hurley
- Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Marie Hutchinson
- Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Desiree Kozlowski
- Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Martin Gadd
- Mid North Coast LHD, Coffs Harbour, New South Wales, Australia
| | - Stephen van Vorst
- Southern Cross University, Coffs Harbour, New South Wales, Australia
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Key Components of the Safe Surgical Ward: International Delphi Consensus Study to Identify Factors for Quality Assessment and Service Improvement. Ann Surg 2020; 269:1064-1072. [PMID: 31082903 DOI: 10.1097/sla.0000000000002718] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aim of this study was to prioritize key factors contributing to safety on the surgical ward BACKGROUND:: There is a variation in the quality and safety of postoperative care between institutions. These variations may be attributed to a combination of process-related issues and structural factors. The aim of this study is to reach a consensus, by means of Delphi methodology, on the most influential of these components that may determine safety in this environment. METHODS The Delphi questionnaire was delivered via an online questionnaire platform. The panel were blinded. An international panel of safety experts, both clinical and nonclinical, and safety advocates participated. Individuals were selected according to their expertise and extent of involvement in patient safety research, regulation, or patient advocacy. RESULTS Experts in patient safety from the UK, Europe, North America, and Australia participated. The panel identified the response to a deteriorating patient and the care of outlier patients as error-prone processes. Prioritized structural factors included organizational and environmental considerations such as use of temporary staff, out-of-hours reduction in services, ward cleanliness, and features of layout. The latter includes dedicated areas for medication preparation and adequate space around the patient for care delivery. Potential quality markers for safe care that achieved the highest consensus include leadership, visibility between patients and nurses, and nursing team skill mix and staffing levels. CONCLUSION International consensus was achieved for a number of factors across process-related and structural themes that may influence safety in the postoperative environment. These should be championed and prioritized for future improvements in patient safety at the ward-level.
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McInerney P, Green-Thompson LP. Theories of learning and teaching methods used in postgraduate education in the health sciences: a scoping review. JBI Evid Synth 2019; 18:1-29. [PMID: 31567525 DOI: 10.11124/jbisrir-d-18-00022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this scoping review was to determine the theories of learning and methods used in teaching in postgraduate education in the health sciences. The longer-term objective was to use the information gathered to design a workshop for teachers of postgraduate students. INTRODUCTION Whilst undergraduate teaching in the health sciences has received considerable attention in the literature in terms of methods used, innovative ideas and outcomes, the same cannot be said of postgraduate education. A considerable amount of postgraduate teaching takes place in the workplace and often in the form of informal teaching. The increasing complexity of health problems calls for innovative teaching. INCLUSION CRITERIA Papers included in this review were those that considered postgraduate education in the health science disciplines, including but not limited to medicine, nursing, occupational therapy, physiotherapy, pharmacy and dentistry, and that described theories of learning and/or teaching methods used in teaching. METHODS Five databases were searched for the period 2001 through 2016. PubMed yielded the most records (3142). No relevant papers were identified through hand searching of the references of the included papers. A data extraction table was developed and used to extract relevant information from included papers. RESULTS Sixty-one papers were included in the review. Most of the included papers were from the USA, with 17 published in 2015. Descriptive study designs were the most frequently identified study design. Most of the papers were from the medical disciplines. Twenty-seven papers did not refer to a teaching and learning theory, a further group referred to a theory but often towards the end of the paper, and seven papers had as their focus the importance of theories in medical education. The theories named were of a wide variety. Likewise, a wide range of teaching methods were identified. CONCLUSIONS It is clear that a range of theories and teaching methods are used in postgraduate health science education, with educators feeling the need to explore more innovative methods.
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Affiliation(s)
- Patricia McInerney
- The Wits-JBI Centre for Evidence-based Practice: a Joanna Briggs Institute Centre of Excellence.,Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lionel Patrick Green-Thompson
- The Wits-JBI Centre for Evidence-based Practice: a Joanna Briggs Institute Centre of Excellence.,Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Ounounou E, Aydin A, Brunckhorst O, Khan MS, Dasgupta P, Ahmed K. Nontechnical Skills in Surgery: A Systematic Review of Current Training Modalities. JOURNAL OF SURGICAL EDUCATION 2019; 76:14-24. [PMID: 30122636 DOI: 10.1016/j.jsurg.2018.05.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 05/16/2018] [Accepted: 05/27/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The complexity of the operating room requires a surgeon to have both technical ability and an array of nontechnical skills. The emphasis on technical skills during surgical training is well established, however it is deficiencies in nontechnical skills that have been identified as the main cause of errors in the operating room. OBJECTIVE This systematic review aims to identify current methods used to teach nontechnical skills and how these methods are assessed to determine their validity, evidence, and role in training. METHODS MEDLINE and Embase databases were searched for English language articles between 2000 and 2017 for nontechnical surgical skills training. Original research articles were included if they described non-technical surgical skills training modalities and their assessment. Results were assessed for the level of evidence and each modality was awarded a level of recommendation, using a modified educational Oxford Centre for Evidence-Based Medicine classification, as adapted by the European Association of Endoscopic Surgery. RESULTS A total of 19 studies were identified pertaining to high fidelity simulation (n = 8), low fidelity simulation (n = 6), didactic teaching (n = 2) and crisis resource management (n = 3). Of the included studies 1 was classified Level 1b, 1 level 2b, 7 level 2b, 2 level 2c, and 8 level 3. CONCLUSION With the importance of nontechnical skills being increasingly recognized, it is essential for surgeons to receive adequate training in nontechnical skills. Therefore the most valuable teaching modalities such as high and low fidelity simulation needs to be implemented into surgical training curricula.
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Affiliation(s)
- Esther Ounounou
- MRC Centre for Transplantation, King's College London, Department of Urology, Guy's and St. Thomas' NHS Foundation Trust King's Health Partners, London, United Kingdom
| | - Abdullatif Aydin
- MRC Centre for Transplantation, King's College London, Department of Urology, Guy's and St. Thomas' NHS Foundation Trust King's Health Partners, London, United Kingdom.
| | - Oliver Brunckhorst
- MRC Centre for Transplantation, King's College London, Department of Urology, Guy's and St. Thomas' NHS Foundation Trust King's Health Partners, London, United Kingdom
| | - M Shamim Khan
- MRC Centre for Transplantation, King's College London, Department of Urology, Guy's and St. Thomas' NHS Foundation Trust King's Health Partners, London, United Kingdom
| | - Prokar Dasgupta
- MRC Centre for Transplantation, King's College London, Department of Urology, Guy's and St. Thomas' NHS Foundation Trust King's Health Partners, London, United Kingdom
| | - Kamran Ahmed
- MRC Centre for Transplantation, King's College London, Department of Urology, Guy's and St. Thomas' NHS Foundation Trust King's Health Partners, London, United Kingdom
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Acheampong DO, Paul P, Guerrier S, Boateng P, Leitman IM. Effect of Resident Involvement on Morbidity and Mortality Following Thoracic Endovascular Aortic Repair. JOURNAL OF SURGICAL EDUCATION 2018; 75:1575-1582. [PMID: 29709469 DOI: 10.1016/j.jsurg.2018.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 03/27/2018] [Accepted: 04/08/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To evaluate the effect of resident involvement in thoracic endovascular aortic repair (TEVAR). SUMMARY OF BACKGROUND DATA Although the influence of resident intraoperative involvement in several types of surgical procedures has been reported, the effect of resident participation in TEVAR is unknown. We evaluated patient outcomes in resident-involved TEVAR procedures. METHODS The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was analyzed for TEVAR performed from 2010 to 2012. Current procedural terminology codes were used to identify adult patients (≥18 y) who underwent TEVAR. Patients were grouped into those with and without resident involvement. Descriptive and binomial logistic statistics were used to determine the effect of resident involvement on post-TEVAR outcomes. p values < 0.05 were considered statistically significant. RESULTS A total of 676 patients met inclusion criteria for this study. Of these, 517 (76.5%) had residents involved. Overall mortality was 9.8%, with no significant difference between the 2 groups (p = 0.88). Resident involvement was not a significant predictor of any post-TEVAR complication. Postoperative pneumonia (3.5% vs 6.9%, p = 0.06), prolonged mechanical ventilation (11.8% vs 11.9%, p = 0.96), stroke (2.7% vs 5.7%, p = 0.07), urinary tract infection (3.3% vs 4.4%, p = 0.50), progressive renal insufficiency (1.2% vs 2.5%, p = 0.22), acute renal failure (4.1% vs 5.0%, p = 0.60), cardiac arrest (2.9% vs 5.0%, p = 0.20), myocardial infarction (1.7% vs 1.9%, p = 0.91), deep venous thrombosis (1.7% vs 1.3%, p = 0.67), red blood cells transfusions (29.2% vs 36.5%, p = 0.08), sepsis (2.9% vs 4.4%, p = 0.35), septic shock (1.9% vs 3.8%, p = 0.18), and unplanned reintubation (8.7% vs 9.4%, p = 0.78) were not significantly affected. Additionally, resident involvement did not significantly affect operative time (176.1 ± 122.8 min vs 180.3 ± 119.1 min, p = 0.71) and anesthesia time (282.1 ± 146.6 min vs 278.3 ± 140.5 min, p = 0.78). CONCLUSIONS The participation of residents in TEVAR did not significantly affect all 30-day patient outcomes. Resident involvement in TEVAR is safe and should be encouraged. MINI ABSTRACT This study evaluated the effect of resident participation on postoperative outcomes of thoracic endovascular aortic repair (TEVAR) using the American College of Surgeons National Surgical Quality Improvement (ACS-NSQIP) database. Results showed that resident involvement in TEVAR does not negatively affect patient outcomes.
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Affiliation(s)
- Derrick O Acheampong
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Philip Paul
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Shanice Guerrier
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Percy Boateng
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - I Michael Leitman
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
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Kempton SJ, Salyapongse AN, Israel JS, Mandel BA. Surgical Education Module Improves Operative Proficiency in Endoscopic Carpal Tunnel Release: A Blinded Randomized Controlled Trial of Trainees. JOURNAL OF SURGICAL EDUCATION 2018; 75:442-449. [PMID: 29033271 DOI: 10.1016/j.jsurg.2017.08.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 07/25/2017] [Accepted: 08/05/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The purpose of this study is to evaluate whether an interactive endoscopic carpal tunnel release (ECTR) surgical education module can improve knowledge of surgical indications and improve procedural competency. DESIGN An ECTR education module was developed and trainees at various level of training were enrolled and randomized to surgical module and nonmodule (control) groups. Subjects were instructed that they would be the primary surgeon performing an ECTR. A written assessment was administered before and after module completion or independent case preparation to test comprehension of the procedure. The senior author evaluated each subject's intraoperative performance using a 5-point scoring system. Statistical analysis was performed using chi-square and paired t-tests. SETTING This study took place at a tertiary care hospital at the University of Wisconsin. RESULTS In all, 30 subjects were tested (15 surgical module and 15 nonmodule). There were no differences in prepreparation test scores between groups. Postpreparation test scores following use of the module were significantly higher compared to the nonmodule group. The average operation performance scores for the surgical module group and nonmodule group were 96% and 82%, respectively. The surgical module group performed significantly better on all operative steps except for dressing application. Surgical module subjects without prior ECTR experience (n = 7) had operative scores that were significantly higher than those for nonmodule subjects without previous ECTR experience (n = 8) (95% vs. 75%). There was no difference in operative scores between surgical module subjects with no prior experience (n = 7) and nonmodule subjects who had performed at least 1 prior case (n = 7) (95% vs. 89%). CONCLUSIONS The use of an ECTR surgical education module demonstrates a significant benefit in ECTR-naïve subjects. When compared to subjects with previous ECTR experience, ECTR-naïve subjects trained using the surgical module demonstrate better familiarity with the equipment and equivalent performance of the procedure.
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Affiliation(s)
- Steve J Kempton
- Division of Plastic and Reconstructive Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin.
| | - A Neil Salyapongse
- Division of Plastic and Reconstructive Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin
| | - Jacqueline S Israel
- Division of Plastic and Reconstructive Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin
| | - Benjamin A Mandel
- Division of Plastic and Reconstructive Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin
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Pires S, Monteiro S, Pereira A, Chaló D, Melo E, Rodrigues A. Non-technical skills assessment for prelicensure nursing students: An integrative review. NURSE EDUCATION TODAY 2017; 58:19-24. [PMID: 28818708 DOI: 10.1016/j.nedt.2017.07.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 07/28/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND In nursing, non-technical skills are recognized as playing an important role to increase patient safety and successful clinical outcomes (Pearson and McLafferty, 2011). Non-technical skills are cognitive and social resource skills that complement technical skills and contribute to safe and efficient task performance (Flin et al., 2008). In order to effectively provide non-technical skills training, it is essential to have an instrument to measure these skills. METHODOLOGY An online search was conducted. Articles were selected if they referred to and/or described instruments assessing non-technical skills for nurses and/or prelicensure nursing students in educational, clinical and/or simulated settings with validation evidence (inclusion criteria). RESULTS Of the 53 articles located, 26 met the inclusion criteria. Those referred to and/or described 16 instruments with validation evidence developed to assess non-technical skills in multidisciplinary teams including nurses. CONCLUSION Although articles have shown 16 valid and reliable instruments, to our knowledge, no instrument has been published or developed and validated for the assessment of non-technical skills of only nurses in general, relevant for use in high-fidelity simulation-based training for prelicensure nursing students. Therefore, there is a need for the development of such an instrument.
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Affiliation(s)
- Sara Pires
- Departamento de Educação, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; Cintesis - Center for Health Technology and Services Research, Piso 2, edifício nascente, Centro de Investigação Médica, Faculdade de Medicina da Universidade do Porto, Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal.
| | - Sara Monteiro
- Departamento de Educação, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; Cintesis - Center for Health Technology and Services Research, Piso 2, edifício nascente, Centro de Investigação Médica, Faculdade de Medicina da Universidade do Porto, Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal.
| | - Anabela Pereira
- Departamento de Educação, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; Centro de Investigação Didáctica e Tecnologia na Formação de Formadores, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal.
| | - Daniela Chaló
- Escola Superior de Saúde da Universidade de Aveiro, Edifício 30 - Agras do Crasto, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; SIMULA - Centro de Simulação Clínica da Universidade de Aveiro, Edifício 30 - Agras do Crasto, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal..
| | - Elsa Melo
- SIMULA - Centro de Simulação Clínica da Universidade de Aveiro, Edifício 30 - Agras do Crasto, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal.; Escola Superior de Saúde da Universidade de Aveiro, Edifício 30 - Agras do Crasto, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal.
| | - Alexandre Rodrigues
- SIMULA - Centro de Simulação Clínica da Universidade de Aveiro, Edifício 30 - Agras do Crasto, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal.; Escola Superior de Saúde da Universidade de Aveiro, Edifício 30 - Agras do Crasto, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal.
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Caskey RC, Owei L, Rao R, Riddle EW, Brooks AD, Dempsey DT, Morris JB, Neylan CJ, Williams NN, Dumon KR. Integration of Hands-On Team Training into Existing Curriculum Improves Both Technical and Nontechnical Skills in Laparoscopic Cholecystectomy. JOURNAL OF SURGICAL EDUCATION 2017; 74:915-920. [PMID: 28566217 DOI: 10.1016/j.jsurg.2017.05.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 04/12/2017] [Accepted: 05/09/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Nontechnical skills are an essential component of surgical education and a major competency assessed by the ACGME milestones project. However, the optimal way to integrate nontechnical skills training into existing curricula and then objectively evaluate the outcome is still unknown. The aim of this study was to determine the effect laparoscopic team-based task training would have on the nontechnical skills needed for laparoscopic surgery. DESIGN 9 PGY-1 residents underwent an established training curriculum for teaching the knowledge and technical skills involved in laparoscopic cholecystectomy. Initial training involved a didactic session, expert-led practice on a porcine model in a simulated operating room and laparoscopic skills practice on a virtual reality trainer. Residents then performed a laparoscopic cholecystectomy on the same porcine model as a preintervention test. Three to four months following this, residents were subjected to specific nontechnical skills training involving 2 simple team-based laparoscopic tasks. They then practiced a further 4 to 6 hours on the virtual reality trainer. A repeat postintervention laparoscopic cholecystectomy was then performed 3 to 4 months after nontechnical skills training. Both the preintervention and postintervention laparoscopic cholecystectomies were audiovisually recorded and then evaluated by 2 independent surgeons in a blinded fashion. Technical skills were assessed using objective structured assessment of technical skills (OSATS) and a technique specific rating scale (TRS) that we developed for laparoscopic cholecystectomy. Nontechnical skills were assessed using nontechnical skills for surgeons (NOTSS). Residents also completed a survey at the beginning and end of the training. SETTING Tertiary care, university based teaching institution. PARTICIPANTS A total of 9 general surgery residents at the intern level. RESULTS The mean OSATS score improved from 13.7 ± 1.24 to 26.7 ± 0.31 (p < 0.001), the mean TRS score improved from 6 ± 0.46 to 13.1 ± 0.36 (p < 0.001) and the mean NOTSS score improved from 21.7 ± 1.83 to 36.3 ± 0.87 (p < 0.001) following the training. There was a strong correlation between OSATS and NOTSS scores (Pearson's R = 0.98) and TRS and NOTSS (R = 0.94). The inter-rater agreement was 0.79 for NOTSS, 0.9 for OSATS, and 0.82 for TRS. Following completion of the training, residents self-reported improvements in exchanging information (p < 0.01), coordinating activities (p < 0.01) and coping with pressure in the operating room (p < 0.001). CONCLUSION Simple, team-based nontechnical skills training for laparoscopic cholecystectomy that was separate from technical skills training led to a sustained increase in residents' nontechnical skills 3 to 4 months after training. This was associated with a self-reported improvement in many nontechnical skills based on resident survey. Based on these results, we recommend that such designated nontechnical skills training is a valid alternative to other methods such as coaching and debriefing. We, therefore, plan to continue our efforts to develop team-based simulation tasks aimed at improving nontechnical skills for multiple surgical modalities.
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Affiliation(s)
- Robert C Caskey
- Division of Surgical Education, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Lily Owei
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Raghavendra Rao
- Division of Surgical Education, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Elijah W Riddle
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ari D Brooks
- Division of Surgical Education, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Daniel T Dempsey
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jon B Morris
- Division of Surgical Education, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Christopher J Neylan
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Noel N Williams
- Division of Surgical Education, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Penn Medicine Simulation Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kristoffel R Dumon
- Division of Surgical Education, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Penn Medicine Simulation Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
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15
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Wood TC, Raison N, Haldar S, Brunckhorst O, McIlhenny C, Dasgupta P, Ahmed K. Training Tools for Nontechnical Skills for Surgeons-A Systematic Review. JOURNAL OF SURGICAL EDUCATION 2017; 74:548-578. [PMID: 28011262 DOI: 10.1016/j.jsurg.2016.11.017] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 09/11/2016] [Accepted: 11/28/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Development of nontechnical skills for surgeons has been recognized as an important factor in surgical care. Training tools for this specific domain are being created and validated to maximize the surgeon's nontechnical ability. This systematic review aims to outline, address, and recommend these training tools. DESIGN A full and comprehensive literature search, using a systematic format, was performed on ScienceDirect and PubMed, with data extraction occurring in line with specified inclusion criteria. SETTING Systematic review was performed fully at King's College London. RESULTS A total of 84 heterogeneous articles were used in this review. Further, 23 training tools including scoring systems, training programs, and mixtures of the two for a range of specialities were identified in the literature. Most can be applied to surgery overall, although some tools target specific specialities (such as neurosurgery). Interrater reliability, construct, content, and face validation statuses were variable according to the specific tool in question. CONCLUSIONS Study results pertaining to nontechnical skill training tools have thus far been universally positive, but further studies are required for those more recently developed and less extensively used tools. Recommendations can be made for individual training tools based on their level of validation and for their target audience. Based on the number of studies performed and their status of validity, NOTSS and Oxford NOTECHS II can be considered the gold standard for individual- and team-based nontechnical skills training, respectively, especially when used in conjunction with a training program.
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Affiliation(s)
- Thomas Charles Wood
- Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Nicholas Raison
- MRC Centre for Transplantation, Guy's Hospital, King's College London, London, United Kingdom.
| | - Shreya Haldar
- Department of Opthalmology, Stoke Mandeville Hospital, Aylesbury, United Kingdom
| | - Oliver Brunckhorst
- MRC Centre for Transplantation, Guy's Hospital, King's College London, London, United Kingdom
| | - Craig McIlhenny
- Department of Urology, NHS Forth Valley, Larbert, United Kingdom
| | - Prokar Dasgupta
- MRC Centre for Transplantation, Guy's Hospital, King's College London, London, United Kingdom
| | - Kamran Ahmed
- MRC Centre for Transplantation, Guy's Hospital, King's College London, London, United Kingdom
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Abstract
Simulation can be an effective tool to facilitate the acquisition and maintenance of the cognitive, technical and behavioral skills necessary to carry out our mission in neonatology: the delivery of safe, effective and efficient care to our patients. Prominent examples of successful implementation of simulation within neonatology include the Neonatal Resuscitation Program, the International Pediatric Simulation Society, and the International Network for Simulation-Based Pediatric Innovation, Research and Education. Despite these successes much remains to be accomplished. Expanding simulation beyond technical skill acquisition, using simulated environments to conduct research into human and system performance, incorporating simulation into high-stakes skill assessments, embracing the expertise of the more extensive modeling and simulation community and, in general, applying simulation to healthcare with the same degree of gravitas with which it is deployed in other high-risk industries are all tasks that must be completed in order to achieve our mission.
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Affiliation(s)
- Louis P Halamek
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, School of Medicine, Stanford University, Stanford, CA.
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Drudi L, Hossain S, Mackenzie KS, Corriveau MM, Abraham CZ, Obrand DI, Vassiliou M, Gill H, Steinmetz OK. A National Survey on Teaching and Assessing Technical Proficiency in Vascular Surgery in Canada. Ann Vasc Surg 2016; 33:220-6. [DOI: 10.1016/j.avsg.2015.11.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 11/20/2015] [Accepted: 11/30/2015] [Indexed: 11/28/2022]
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