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Larkins K, Downie E, Mohan H, Warrier S, Heriot A. How to watch: a guide to structured operative observation and cognitive simulation for trainees. ANZ J Surg 2024; 94:8-10. [PMID: 37872825 DOI: 10.1111/ans.18745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 10/25/2023]
Affiliation(s)
- Kirsten Larkins
- Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Department of General Surgery, Austin Health, Melbourne, Victoria, Australia
- Department of Surgery, Melbourne University, Melbourne, Victoria, Australia
| | - Emma Downie
- Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Helen Mohan
- Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Department of General Surgery, Austin Health, Melbourne, Victoria, Australia
| | - Satish Warrier
- Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Department of Surgery, Melbourne University, Melbourne, Victoria, Australia
- Department of General Surgery, Alfred Health, Melbourne, Victoria, Australia
- Department of Surgery, Monash University, Melbourne, Victoria, Australia
| | - Alexander Heriot
- Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Department of Surgery, Melbourne University, Melbourne, Victoria, Australia
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Cardoso SA, Suyambu J, Iqbal J, Cortes Jaimes DC, Amin A, Sikto JT, Valderrama M, Aulakh SS, Ramana V, Shaukat B, Patel T. Exploring the Role of Simulation Training in Improving Surgical Skills Among Residents: A Narrative Review. Cureus 2023; 15:e44654. [PMID: 37799263 PMCID: PMC10549779 DOI: 10.7759/cureus.44654] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 09/04/2023] [Indexed: 10/07/2023] Open
Abstract
The role of simulation in medical education is crucial to the development of surgeons' skills. Surgical simulation can be used to improve surgical skills in a secure and risk-free environment. Animal models, simulated patients, virtual reality, and mannequins are some types of surgical simulation. As a result, feedback encourages students to reflect on their strengths and weaknesses, enabling them to focus on improvement. Healthcare simulation is a strong educational instrument, and the main goal of this is to give the students an opportunity to do a practical application of what they have learned through theory. Before taking it to the patients, they will already have certain tools they have previously acquired during the practice. This makes it easier for students to identify the knowledge gaps that they must fill to improve patient outcomes. Moreover, simulation brings a wonderful opportunity for students to acquire skills, gain confidence, and experience success before working with real patients, especially when their clinical exposure is limited. The use of simulation to teach technical skills to surgical trainees has become more prevalent. The cost of setting up a simulation lab ranges from $100,000 to $300,000. There are several ways to evaluate the effectiveness of simulation-based surgical training. Repetitive surgical simulation training can improve speed and fluidity in general surgical skills in comparison to conventional training. Few previous studies compared learners who received structured simulation training to a group of trainees who did not receive any simulation training in single-center randomized control research. Significantly faster and less time-consuming skill proficiency was noticeable in simulated trainees. Despite being anxious in the operating room for the first time, simulated trainees completed the surgery on time, demonstrating the effectiveness of surgical simulation training. Traditional surgical training involves senior-surgeon supervision in the operating room. In simulation-based training, the trainees have full control over clinical scenarios and settings; however, guidance and assessment are also crucial. Simulators allow users to practice tasks under conditions resembling real-life scenarios. Simulators can be compared with traditional surgical training methods for different reasons. For example, intraoperative bleeding may occasionally show up not only visibly on the screen but also by shaking the trocars erratically. Without haptics, training on virtual simulators can cause one's pulling and pushing forces, which are frequently greater than what the tissue needs, to be distorted. A good method of simulation training is using virtual reality simulators with haptics and simulated patients. The availability of these facilities is limited, though, and a typical session might include an exercise involving stacking sugar cubes and box trainers. The degree of expertise or competency is one area that needs clarification as medical education transitions to a competency-based paradigm. The article aims to provide an overview of simulation, methods of simulation training, and the key role and importance of surgical simulation in improving skills in surgical residents.
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Affiliation(s)
- Swizel Ann Cardoso
- Major Trauma Services, University Hospital Birmingham National Health Service (NHS) Foundation Trust, Birmingham, GBR
| | - Jenisha Suyambu
- Medical Education, Jonalta School of Medicine, University of Perpetual Help System Dalta, Laspinas City, PHL
| | | | - Diana Carolina Cortes Jaimes
- Epidemiology, Universidad Autónoma de Bucaramanga, Bucaramanga, COL
- Medicine, Pontificia Universidad Javeriana, Bogotá, COL
| | - Aamir Amin
- Cardiothoracic Surgery, Guy's and St Thomas National Health Service (NHS) Foundation Trust, London, GBR
| | - Jarin Tasnim Sikto
- College of Medicine, Jahurul Islam Medical College and Hospital, Kishoreganj, BGD
| | | | | | - Venkata Ramana
- Orthopedics, All India Institute of Medical Sciences, Mangalagiri, IND
| | | | - Tirath Patel
- College of Medicine, American University of Antigua, St. John, ATG
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Chatterton BD, Sharma N, Rees EL, Hadfield-Law L, Jermin PJ, Banerjee R, Kiely NT. Twelve tips for optimising learning for postgraduate doctors in the operating theatre. MEDICAL TEACHER 2023; 45:972-977. [PMID: 37105593 DOI: 10.1080/0142159x.2023.2206536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Learning in the operating theatre forms a critical part of postgraduate medical education. Postgraduate doctors present a diverse cohort of learners with a wide range of learning needs that will vary by their level of experience and curriculum requirements. With evidence of both trainee dissatisfaction with the theatre learning experience and reduced time spent in the operating theatre, which has been exacerbated by the effects of the Covid-19 pandemic, it is vital that every visit to the operating theatre is used as a learning opportunity. We have devised 12 tips aimed at both learners and surgeons to optimise learning in the operating theatre, set out into four domains: educational context, preparation, learning in theatre, feedback and reflection. These tips have been created by a process of literature review and acknowledgment of established learning theory, with further discussion amongst surgical trainees, senior surgical faculty, surgical educators and medical education faculty.
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Affiliation(s)
- Benjamin D Chatterton
- The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, UK
| | - Nikhil Sharma
- The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, UK
| | - Eliot L Rees
- School of Medicine, Keele University, Keele, UK
- Faculty of Population Health Sciences, University College London, London, UK
| | - Lisa Hadfield-Law
- Bailey's Consulting, Surgical Educationalist, British Orthopaedic Association, Charlbury, UK
| | - Paul J Jermin
- The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, UK
| | - Robin Banerjee
- The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, UK
| | - Nigel T Kiely
- The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, UK
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Larkins K, Khan M, Mohan H, Warrier S, Heriot A. A systematic review of video-based educational interventions in robotic surgical training. J Robot Surg 2023:10.1007/s11701-023-01605-y. [PMID: 37097494 DOI: 10.1007/s11701-023-01605-y] [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: 03/20/2023] [Accepted: 04/18/2023] [Indexed: 04/26/2023]
Abstract
As robotic surgical procedures become more prevalent in practice, there is a demand for effective and efficient educational strategies in robotic surgery. Video has been used in open and laparoscopic surgery to instruct trainees in the acquisition of operative knowledge and surgical skill. Robotic surgery is an ideal application of video-based technology given the access of video recording directly from the console. This review will present the evidence base for video-based educational tools in robotic surgery to guide the development of future educational interventions using this technology. A systematic review of the literature was performed using the key words "video" "robotic surgery" and "education". From a total of 538 results, 15 full text articles were screened. Inclusion criteria were the presentation of an educational intervention using video and the application of this intervention to robotic surgery. The results of 10 publications are presented in this review. Analysis of the key concepts presented in these publications revealed three themes: video as technology, video as instruction, video as feedback. All studies showed a video-based learning had a positive effect on educational outcomes. There are limited published studies looking specifically at the use of video as an educational intervention in robotic surgical training. Existing studies primarily focus on the use of video as a review tool for skill development. There is scope to expand the use of robotic video as a teaching tool through adaptation of novel technology such as 3D headsets and concepts of cognitive simulation including guided mental imagery and verbalisation.
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Affiliation(s)
- Kirsten Larkins
- Peter MacCallum Cancer Centre, 300 Grattan Street, Melbourne, VIC, 3000, Australia.
| | | | - Helen Mohan
- Department of Colorectal Surgery, Austin Health, Heidelberg, VIC, Australia
| | - Satish Warrier
- Peter MacCallum Cancer Centre, 300 Grattan Street, Melbourne, VIC, 3000, Australia
- International Medical Robotics Academy, North Melbourne, VIC, Australia
| | - Alexander Heriot
- Peter MacCallum Cancer Centre, 300 Grattan Street, Melbourne, VIC, 3000, Australia
- International Medical Robotics Academy, North Melbourne, VIC, Australia
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Fitzgerald MC, Noonan M, Lim E, Mathew JK, Boo E, Stergiou HE, Kim Y, Reilly S, Groombridge C, Maini A, Williams K, Mitra B. Multi-disciplinary, simulation-based, standardised trauma team training within the Victorian State Trauma System. Emerg Med Australas 2023; 35:62-68. [PMID: 36052421 PMCID: PMC10087482 DOI: 10.1111/1742-6723.14068] [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: 09/02/2021] [Revised: 04/26/2022] [Accepted: 07/24/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Inconsistency in the structure and function of team-based major trauma reception and resuscitation is common. A standardised trauma team training programme was initiated to improve quality and consistency among trauma teams across a large, mature trauma system. The aim of this manuscript is to outline the programme and report on the initial perception of participants. METHODS The Alfred Trauma Team Reception and Resuscitation Training (TTRRT) programme commenced in March 2019. Participants included critical care and surgical craft group members commonly involved in trauma teams. Training was site-specific and included rural, urban and tertiary referral centres. The programme consisted of prescribed pre-learning, didactic lectures, skill stations and simulated team-based scenarios. Participant perceptions of the programme were collected before and after the programme for analysis. RESULTS The TTRRT was delivered to 252 participants and 120 responses were received. Significant improvement in participant-reported confidence was identified across all key topic areas. There was also a significant increase in both confidence and clinical exposure to trauma team leadership roles after participation in the programme (from 53 [44.2%] to 74 [61.7%; P = 0.007]). This finding was independent of clinician experience. CONCLUSIONS A team-based trauma reception and resuscitation education programme, introduced in a large, mature trauma system led to positive participant-reported outcomes in clinical confidence and real-life team leadership participation. Wider implementation combined with longitudinal data collection will facilitate correlation with patient and staff-centred outcomes.
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Affiliation(s)
- Mark C Fitzgerald
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.,Trauma Service, The Alfred Hospital, Melbourne, Victoria, Australia.,Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Michael Noonan
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.,Trauma Service, The Alfred Hospital, Melbourne, Victoria, Australia.,Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Emma Lim
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Joseph K Mathew
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.,Trauma Service, The Alfred Hospital, Melbourne, Victoria, Australia.,Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Ellaine Boo
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Helen E Stergiou
- Trauma Service, The Alfred Hospital, Melbourne, Victoria, Australia.,Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Yesul Kim
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.,Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Stephanie Reilly
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.,Trauma Service, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Christopher Groombridge
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.,Trauma Service, The Alfred Hospital, Melbourne, Victoria, Australia.,Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Amit Maini
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.,Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Kim Williams
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.,Trauma Service, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Biswadev Mitra
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.,Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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