Instituting a Surgical Skills Competition Increases Technical Performance of Surgical Clerkship Students Over Time

Trainee-perceived benefits of a virtual temporal bone competition

OBJECTIVE

To assess the perceived benefits of a novel educational approach for otolaryngology trainees: a virtual reality temporal bone simulator drilling competition.

METHODS

Regional otolaryngology trainees participated in the competition. Drilling activities using the Voxel-Man TempoSurg simulator were scored by experts. Questionnaires that contained questions covering motivators for attending, perceived learning and enjoyment were sent to participants. Agreement with statements was measured on a 10-point Likert scale (1 = strongly disagree, 10 = strongly agree).

RESULTS

Eighteen trainees participated. The most cited reason for attending was for learning and/or education (61 per cent), with most attendees (72 per cent) believing that competition encourages more reading and/or practice. Seventeen attendees (94 per cent) believed Voxel-Man TempoSurg-based simulation would help to improve intra-operative performance in mastoidectomy (mean 7.83 ± 1.47, p < 0.001) and understanding of anatomy (mean 8.72 ± 1.13, p < 0.001). All participants rated the competition as 'fun' and 83 per cent believed the competitive element added to this.

CONCLUSION

The virtual reality temporal bone competition is a novel educational approach within otolaryngology that was positively received by otolaryngology trainees.

Development of an innovative educational escape game to promote teamwork in dentistry

BACKGROUND

Escape games have proven to be an innovative pedagogical tool that allows students to use the professional skills they acquired. The appeal of the game lies in the stimulation of the players' minds and in the diversity of the puzzles.

PURPOSE/OBJECTIVES

To evaluate the effectiveness of an educational tool aimed at cultivating team spirit and group cohesion in dentistry students through a fun collaborative activity that mobilises their knowledge and skills.

MATERIALS AND METHOD

Twenty-four students participated to the escape game over a one-day period. In order to win, they had to solve dentistry-related puzzles.

RESULTS

Feedback was strongly positive. The balance between manipulations and theoretical questions stimulated them. Students did favour this type of activity which allows to increase interactions between students as well as with the teaching team.

CONCLUSION

Escape games in dental schools foster a supportive learning environment and stimulated students' motivation and group cohesion.

Surgical Skills Olympiad: A 4-Year Experience in a General Surgery Residency Program

Background  The acquisition of operative skills is the critical defining component of general surgery training. Performing simulated tasks has been shown to increase a resident's technical skills. As such, we devised the Surgical Skills Olympiad, an annual simulation-based skills competition. We examined our 4-year experience with the Olympiad at a large academic general surgery residency program.

Objective  This study aimed to use competition to motivate trainees to increase the time they spent practicing basic surgical skills, resulting in improved performance over time.

Methods  Teams were formed from members of each postgraduate year (PGY) class. Competition tasks were level specific: knot tying for PGY-1, basic laparoscopy for PGY-2, handsewn bowel anastomosis for PGY-3, vascular anastomosis for PGY-4, and advanced laparoscopy for PGY-5. Task scores over a 4-year period (2014–2017) were analyzed and a survey of participating teaching faculty was conducted.

Results  Ten faculty members responded to the survey, for a response rate of 63%. A total of 50% respondents felt that the caliber of surgical skills increased since the Olympiad was implemented. Ninety percent agreed that the Olympiad was beneficial for residents to assess their skills against their peers. Over 4 years, there was an improvement in scores for suturing task, advanced laparoscopy, and bowel anastomosis ( p  < 0.05 for all three).

Conclusion  A residency-wide surgical skills competition can improve resident performance in technical tasks and promote faculty engagement in resident skills training.

Changing the Status Quo: Developing a Virtual Sub-Internship in the Era of COVID-19

PROBLEM

Subinternships are integral to medical education as tools for teaching and assessing fourth-year medical students. Social distancing due to COVID-19 has precluded the ability to offer in-person subinternships - negatively impacting medical education and creating uncertainty surrounding the residency match. With no precedent for the development and implementation of virtual subinternships, the Society of Academic Urologists (SAU) developed an innovative and standardized curriculum for the Virtual Subinternship in Urology (vSIU).

METHODS

The vSIU committee's mandate was to create a standardized curriculum for teaching foundational urology and assessing student performance. Thirty-three members from 23 institutions were divided into working groups and given 3 weeks to develop 10 modules based on urologic subspecialties, Accreditation Council for Graduate Medical Education core competencies, technical skills training and student assessment. Working groups were encouraged to develop innovative learning approaches. The final curriculum was assembled into the "vSIU Guidebook."

RESULTS

The vSIU Guidebook contains 212 pages - 64 pages core content and 2 appendices (patient cases and evaluations). It outlines a detailed 4-week curriculum with a sufficient volume of resources to offer a completely adaptable virtual course with the same rigor as a traditional subinternship. Modules contain curated teaching resources including journal articles, lectures, surgical videos and simulated clinical scenarios. Innovative learning tools include reflective writing, mentorship guidelines, videoconference-based didactics, surgical simulcasting and virtual technical skills training. The guidebook was disseminated to program directors nationally.

NEXT STEPS

The vSIU is the first virtual subinternship in any specialty to be standardized and offered nationally, and it was implemented by at least 19 urology programs. This curriculum serves as a template for other specialties looking to develop virtual programs and feedback from educators and students will allow the curriculum to evolve. As the pandemic continues to challenge our paradigm, this rapid and innovative response exemplifies that the medical community will continue to meet the needs of an ever-changing educational landscape.

Medical students' perception of what embodies an effective surgeon educator

BACKGROUND

Effective surgeon educators likely help medical students develop competency and may inspire pursuit of surgical training. We sought to determine the qualities medical students believe embody effective surgical educators.

METHODS

Mixed-methods study of nationally electronically recruited 3rd-year medical students using virtual semi-structured interviews and anonymous quantitative survey to determine the most critical and most frequently encountered qualities of effective surgical educators. Thematic analysis using grounded theory was undertaken.

RESULTS

Data saturation occurred after 9 interviews. Themes of effective surgical educators included: engagement (acknowledging student, knowing their name, talking to the student), fostering a positive learning environment (non-threatening, non-shaming questioning), inclusion (giving responsibility/appropriate autonomy), and understanding how to teach a novice (teaching the student how to learn, adapt to learner). On quantitative analysis of Likert based survey, encouraging, promoting a positive learning climate, timely constructive feedback, and questioning were ranked as most critical.

CONCLUSION

Students highly value positive learning climate and inclusion. Faculty Development to promote these traits may improve clerkship learning and experience.

Cognitive training for robotic surgery: a chance to optimize surgical training? A pilot study

The rapid rise of robotic-assisted surgery (RAS) has necessitated an efficient and standardized training curriculum. Cognitive training (CT) can significantly improve skills, such as attention, working memory and problem solving, and can enhance surgical capacity and support RAS training. This pilot study was carried out between 02/2019 and 04/2019. The participants included 33 student volunteers, randomized into 3 groups: group 1 received training using the da Vinci training simulator, group 2 received computer-based cognitive training, and group 3 was the control group without training. Before (T1) and after-training (T2), performance was measured. Additionally, expert ratings and self-evaluations were collected. Subjective evaluations of performance were supplemented by evaluations based on three scales from the revised NEO Personality Inventory (NEO PI-R). In total, 25 probands remained with complete data for further analyses: n = 8 (group 1), n = 7 (group 2) and n = 10 (group 3). There were no significant differences in T1 and T2 among all three groups. The average training gain of group 1 and 2 was 15.87% and 24.6%, respectively, (a restricting condition is the loss of the last training session in group 2). Analyses of semi-structured psychological interviews (SPIs) revealed no significant differences for T1, but in T2, significance occurred at ‘self-reflection’ for group 2 (F(2.22) = 8.56; p < .005). The efficacy of CT in training highly complex and difficult procedures, such as RAS, is a proven and accepted fact. Further investigation involving higher numbers of training trials (while also being cost effective) should be performed.

The Career Impact of the National Undergraduate Neuroanatomy Competition

BACKGROUND

Neurosurgery is a notoriously difficult career to enter and requires medical students to engage in extracurricular activities to demonstrate their commitment to the specialty. The National Undergraduate Neuroanatomy Competition (NUNC) was established in 2013 as a means for students to display this commitment as well as academic ability.

METHODS

A bespoke 22-item questionnaire was designed to determine career outcomes and the role of competition attendance in job applications. It was distributed using the SurveyMonkey website to the 87 attendees at the 2013 and 2014 competitions.

RESULTS

Responses were received by 40 competitors (response rate, 46.0%). Twenty-four responders (60.0%) intended to pursue a career in either neurosurgery (n = 18) or neurology (n = 6). This included 10 responders (25.0%) who had successfully entered either neurosurgery (n = 9) or neurology (n = 1). The performance of these 10 was significantly better than the other responders (57.0 ± 13.6% vs. 46.5 ± 13.5% [n = 30]; P = 0.036). Seventeen responders (42.5%) either included their attendance at NUNC in a post-Foundation job application or intend to.

CONCLUSIONS

The NUNC provides the opportunity for medical students to demonstrate their interest in neurosurgery. It has the potential to be used as a tool for recognizing medical students suitable for neurosurgery training.