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Gonçalves MR, Novo de Matos J, Oliveira A, Marinho R, Cadime I, Carlos Alves P, Morales-Conde S, Sousa MCB. Robotic4all project: Results of a hands-on robotic surgery training program. LAPAROSCOPIC, ENDOSCOPIC AND ROBOTIC SURGERY 2023. [DOI: 10.1016/j.lers.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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Tjønnås MS, Guzmán-García C, Sánchez-González P, Gómez EJ, Oropesa I, Våpenstad C. Stress in surgical educational environments: a systematic review. BMC MEDICAL EDUCATION 2022; 22:791. [PMID: 36380334 PMCID: PMC9667591 DOI: 10.1186/s12909-022-03841-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/29/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The effects of stress on surgical residents and how stress management training can prepare residents to effectively manage stressful situations is a relevant topic. This systematic review aimed to analyze the literature regarding (1) the current stress monitoring tools and their use in surgical environments, (2) the current methods in surgical stress management training, and (3) how stress affects surgical performance. METHODS A search strategy was implemented to retrieve relevant articles from Web of Science, Scopus, and PubMed. The 787 initially retrieved articles were reviewed for further evaluation according to the inclusion/exclusion criteria (Prospero registration number CRD42021252682). RESULTS Sixty-one articles were included in the review. The stress monitoring methods found in the articles showed heart rate analysis as the most used monitoring tool for physiological parameters while the STAI-6 scale was preferred for psychological parameters. The stress management methods found in the articles were mental-, simulation- and feedback-based training, with the mental-based training showing clear positive effects on participants. The studies analyzing the effects of stress on surgical performance showed both negative and positive effects on technical and non-technical performance. CONCLUSIONS The impact of stress responses presents an important factor in surgical environments, affecting residents' training and performance. This study identified the main methods used for monitoring stress parameters in surgical educational environments. The applied surgical stress management training methods were diverse and demonstrated positive effects on surgeons' stress levels and performance. There were negative and positive effects of stress on surgical performance, although a collective pattern on their effects was not clear.
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Affiliation(s)
- Maria Suong Tjønnås
- Department of Neuromedicine and Movement Science (INB), Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, N-7491, Trondheim, Norway.
- SINTEF Digital, Health Department, Trondheim, Norway.
| | - Carmen Guzmán-García
- Biomedical Engineering and Telemedicine Centre (GBT), ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Patricia Sánchez-González
- Biomedical Engineering and Telemedicine Centre (GBT), ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid (UPM), Madrid, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Enrique Javier Gómez
- Biomedical Engineering and Telemedicine Centre (GBT), ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid (UPM), Madrid, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Ignacio Oropesa
- Biomedical Engineering and Telemedicine Centre (GBT), ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Cecilie Våpenstad
- SINTEF Digital, Health Department, Trondheim, Norway
- Department of Clinical and Molecular Medicine (IKOM), Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
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Yang M, Peng J, Wang X, Lei H, Li X, Yang K. Reinforcing the effect of microsurgery practice during robotic suturing skill acquisition. Int J Med Robot 2021; 18:e2350. [PMID: 34773438 DOI: 10.1002/rcs.2350] [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: 06/21/2021] [Revised: 10/06/2021] [Accepted: 11/10/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND This study aimed to examine the effectiveness of microsurgery practice during an interval in robotic surgical training. METHODS Two participant groups with 30 trainees each practiced Thread the Rings 1 on a dV-Trainer. There were four 2-h training sessions, with a 72-h interval between each session. Group A received no additional training during the study period. During every interval, Group B practiced a similar 2-h ring penetration exercise using a microscope three times (once every 24 h). RESULTS The 72-h delay between two sessions for Group A caused the forgetting effect. For Group B, additional microscope-based training aided memory retention. After the training session, Group B presented a significantly higher score than Group A in Thread the Ring 1 learning curves. CONCLUSIONS Adding microsurgical skill training into the basic robotic-surgery training curriculum could be helpful because additional trainings with a binocular microscope could improve robotic surgical skill levels.
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Affiliation(s)
- Miao Yang
- Zhongnan Hospital, Wuhan University, Wuhan, China
| | | | | | - Hong Lei
- Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Xinyi Li
- Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Kun Yang
- Zhongnan Hospital, Wuhan University, Wuhan, China
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Jackson T, Cho EE, Nagatomo K, Osman HG, Jeyarajah DR. Teacher and Trainee Learning Together-Dual Console and the 3 Arms. JOURNAL OF SURGICAL EDUCATION 2020; 77:720-722. [PMID: 32146137 DOI: 10.1016/j.jsurg.2020.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 01/23/2020] [Accepted: 01/26/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The purpose of this paper is to propose a method by which the trainer and the trainee can overcome their learning curves together. DESIGN/SETTING/PARTICIPANTS At a tertiary care facility where we have completely done away with the mandatory bedside procedure requirements, residents and fellows start all cases on the console and have graduated responsibilities assigned to them. Bedside assist cases were felt to take away from trainee precious console time when there were only on service for a limited period while providing laparoscopic skill training without any robot-specific experience. This is a cumulative experience of teaching residents and fellows under this system and its results. RESULTS All trainees at a PG 3 level or greater were able to perform advanced hiatal dissection within 5 cases. CONCLUSIONS The authors propose a paradigm that uses all 3 arms of the robot and a dual console system.
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Affiliation(s)
| | - Edward E Cho
- Methodist Richardson Medical Center, Richardson, Texas
| | - Kei Nagatomo
- Methodist Richardson Medical Center, Richardson, Texas
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Chen R, Rodrigues Armijo P, Krause C, Siu KC, Oleynikov D. A comprehensive review of robotic surgery curriculum and training for residents, fellows, and postgraduate surgical education. Surg Endosc 2019; 34:361-367. [PMID: 30953199 DOI: 10.1007/s00464-019-06775-1] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 03/28/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND In 2017, the utilization of robotic-assisted surgery had grown 10-40-fold relative to laparoscopic surgery in common general surgery procedures. The rapid rise in the utilization of robotic-assisted surgery has necessitated a standardized training curriculum. Many curricula are currently being developed and validated. Additionally, advancements in virtual reality simulators have facilitated their integration into robotic-assisted surgery training. This review aims to highlight and discuss the features of existing curricula and robotic-assisted surgery training simulators and to provide updates on their respective validation process. MATERIALS AND METHODS A literature review was conducted using PubMed from 2000-2019 and commercial websites. Information regarding availability, content, and status of validation was collected for each current robotic-assisted surgery curriculum. This review did not qualify as human subjects research, so institutional review board approval was not required. RESULTS The daVinci Technology Training Pathway and Fundamentals of Robotic Surgery are purely web-based and self-paced robotic-assisted surgery training. The Society of American Gastrointestinal and Endoscopic Surgeon Robotic Masters Series, Fundamental Skills of Robot-Assisted Surgery training program, and the Robotics Training Network curriculum require trainees to be on site in order to provide expert feedback on surgical techniques and robot maintenance. Currently, there are few virtual reality simulators for robotic-assisted surgical training available on the market. CONCLUSIONS Didactic courses are available in all of these training programs, but their contents are inconsistent. Furthermore, the availability and nature of hands-on training offered by these curriculums are widely variable.
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Affiliation(s)
- Richard Chen
- College of Medicine, University of Nebraska Medical Center, Nebraska Medical Center, 986245, Omaha, NE, 68198-6245, USA
| | - Priscila Rodrigues Armijo
- Center for Advanced Surgical Technology, University of Nebraska Medical Center, Nebraska Medical Center, 986246, Omaha, NE, 68198-6246, USA
| | - Crystal Krause
- Center for Advanced Surgical Technology, University of Nebraska Medical Center, Nebraska Medical Center, 986246, Omaha, NE, 68198-6246, USA
| | | | - Ka-Chun Siu
- Center for Advanced Surgical Technology, University of Nebraska Medical Center, Nebraska Medical Center, 986246, Omaha, NE, 68198-6246, USA.,College of Allied Health Professions, University of Nebraska Medical Center, Nebraska Medical Center, 984420, Omaha, NE, 68198-4420, USA
| | - Dmitry Oleynikov
- Center for Advanced Surgical Technology, University of Nebraska Medical Center, Nebraska Medical Center, 986246, Omaha, NE, 68198-6246, USA. .,Department of Surgery, University of Nebraska Medical Center, Nebraska Medical Center, 986245, Omaha, NE, 68198-6245, USA.
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Examining validity evidence for a simulation-based assessment tool for basic robotic surgical skills. J Robot Surg 2018; 13:99-106. [DOI: 10.1007/s11701-018-0811-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 04/16/2018] [Indexed: 12/21/2022]
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Goldenberg MG, Lee JY, Kwong JCC, Grantcharov TP, Costello A. Implementing assessments of robot-assisted technical skill in urological education: a systematic review and synthesis of the validity evidence. BJU Int 2018; 122:501-519. [PMID: 29603869 DOI: 10.1111/bju.14219] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To systematically review and synthesise the validity evidence supporting intraoperative and simulation-based assessments of technical skill in urological robot-assisted surgery (RAS), and make evidence-based recommendations for the implementation of these assessments in urological training. MATERIALS AND METHODS A literature search of the Medline, PsycINFO and Embase databases was performed. Articles using technical skill and simulation-based assessments in RAS were abstracted. Only studies involving urology trainees or faculty were included in the final analysis. RESULTS Multiple tools for the assessment of technical robotic skill have been published, with mixed sources of validity evidence to support their use. These evaluations have been used in both the ex vivo and in vivo settings. Performance evaluations range from global rating scales to psychometrics, and assessments are carried out through automation, expert analysts, and crowdsourcing. CONCLUSION There have been rapid expansions in approaches to RAS technical skills assessment, both in simulated and clinical settings. Alternative approaches to assessment in RAS, such as crowdsourcing and psychometrics, remain under investigation. Evidence to support the use of these metrics in high-stakes decisions is likely insufficient at present.
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Affiliation(s)
| | - Jason Y Lee
- Division of Urology, University of Toronto, Toronto, ON, Canada
| | | | - Teodor P Grantcharov
- Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Anthony Costello
- Department of Surgery, Royal Melbourne Hospital, University of Melbourne, Melbourne, Vic, Australia
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Robinson AJ, Miller G, Rukin N. Simulation in urological training: Where are we in 2017? JOURNAL OF CLINICAL UROLOGY 2017. [DOI: 10.1177/2051415817722933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Traditional Halstedian principles are no longer compatible with modern day urological training. Changing patterns of healthcare provision and the advanced nature of minimally invasive urological surgery have resulted in trainees receiving reduced exposure to independent operative experience. The drive towards consultant-delivered care, coupled with the introduction of the European working time directive, necessitate the urology trainee to meet end-of-training competencies with fewer learning opportunities compared with previous generations. Simulation provides an opportunity to compensate for reduced operative experience by augmenting both technical and non-technical skills development. A variety of simulation models can be used from cadaveric, synthetic and animal models to advanced virtual reality to aid surgical training. Whilst simulation is not without limitations, it has the potential to significantly enhance procedural competency and non-technical skills in a risk-free environment. Clear benefits, including equipment familiarity and trainee confidence have been demonstrated. However, direct transferability of these benefits to an operating-theatre is not clearly evident. Whilst not a substitute for clinical practice, simulation is likely to prove itself as a valuable adjunct to urological training. In this narrative review, we examine the current literature on simulation training in relation to urological surgery.
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Affiliation(s)
- Andrew J Robinson
- University Hospital of North Staffordshire NHS Trust, Royal Stoke University Hospital, UK
| | - George Miller
- King’s College London School of Medical Education, UK
| | - Nick Rukin
- Metro North Hospital and Health Service, Redcliffe Hospital, Queensland, Australia
- University of Queensland, Queensland, Australia
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