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Ben Amor A, Farhat H, Alinier G, Ounallah A, Bouallegue O. Evaluation of the implementation of the objective structured clinical examination in health sciences education from a low-income context in Tunisia: A cross-sectional study. Health Sci Rep 2024; 7:e2116. [PMID: 38742094 PMCID: PMC11089342 DOI: 10.1002/hsr2.2116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 04/09/2024] [Accepted: 04/26/2024] [Indexed: 05/16/2024] Open
Abstract
Background Objective structured clinical examination (OSCE) is well-established and designed to evaluate students' clinical competence and practical skills in a standardized and objective manner. While OSCEs are widespread in higher-income countries, their implementation in low-resource settings presents unique challenges that warrant further investigation. Aim This study aims to evaluate the perception of the health sciences students and their educators regarding deploying OSCEs within the School of Health Sciences and Techniques of Sousse (SHSTS) in Tunisia and their efficacity in healthcare education compared to traditional practical examination methods. Methods This cross-sectional study was conducted in June 2022, focusing on final-year Health Sciences students at the SHSTS in Tunisia. The study participants were students and their educators involved in the OSCEs from June 6th to June 11th, 2022. Anonymous paper-based 5-point Likert scale satisfaction surveys were distributed to the students and their educators, with a separate set of questions for each. Spearman, Mann-Whitney U and Krusakll-Wallis tests were utilized to test the differences in satisfaction with the OSCEs among the students and educators. The Wilcoxon Rank test was utilized to examine the differences in students' assessment scores in the OSCEs and the traditional practical examination methods. Results The satisfaction scores were high among health sciences educators and above average for students, with means of 3.82 ± 1.29 and 3.15 ± 0.56, respectively. The bivariate and multivariate analyzes indicated a significant difference in the satisfaction between the students' specialities. Further, a significant difference in their assessment scores distribution in the practical examinations and OSCEs was also demonstrated, with better performance in the OSCEs. Conclusion Our study provides evidence of the relatively high level of satisfaction with the OSCEs and better performance compared to the traditional practical examinations. These findings advocate for the efficacy of OSCEs in low-income countries and the need to sustain them.
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Affiliation(s)
- Asma Ben Amor
- Faculty of Medicine “Ibn El Jazzar”University of SousseSousseTunisia
- Higher School of Health Sciences and TechniquesUniversity of SousseSousseTunisia
| | - Hassan Farhat
- Faculty of Medicine “Ibn El Jazzar”University of SousseSousseTunisia
- Ambulance ServiceHamad Medical CorporationDohaQatar
- Faculty of SciencesUniversity of SfaxSfaxTunisia
| | - Guillaume Alinier
- Ambulance ServiceHamad Medical CorporationDohaQatar
- School of Health and Social WorkUniversity of HertfordshireHatfieldUK
- Weill Cornell Medicine‐QatarDohaQatar
- Faculty of Health and Life SciencesNorthumbria UniversityNewcastle upon TyneUK
| | - Amina Ounallah
- Faculty of Medicine “Ibn El Jazzar”University of SousseSousseTunisia
- Department of DermatologyAcademic Hospital "Farhat Hached"SousseTunisia
| | - Olfa Bouallegue
- Faculty of Medicine “Ibn El Jazzar”University of SousseSousseTunisia
- Microbiology Laboratory, Hygiene and Critical Care DepartmentsAcademic Hospital of SahloulSousseTunisia
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Alghazawi L, Fadel MG, Chen JY, Das B, Robb H, Rodriguez-Luna MR, Fakih-Gomez N, Perretta S, Ashrafian H, Fehervari M. Development and Evaluation of a Quality Assessment Tool for Laparoscopic Sleeve Gastrectomy Videos: A Review and Comparison of Academic and Online Video Resources. Obes Surg 2024; 34:1909-1916. [PMID: 38581627 PMCID: PMC11031436 DOI: 10.1007/s11695-024-07199-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 03/21/2024] [Accepted: 03/21/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Video recording of surgical procedures is increasing in popularity. They are presented in various platforms, many of which are not peer-reviewed. Laparoscopic sleeve gastrectomy (LSG) videos are widely available; however, there is limited evidence supporting the use of reporting guidelines when uploading LSG videos to create a valuable educational video. We aimed to determine the variations and establish the quality of published LSG videos, in both peer-reviewed literature and on YouTube, using a newly designed checklist to improve the quality and enhance the transparency of video reporting. METHODS A quality assessment tool was designed by using existing research and society guidelines, such as the Bariatric Metabolic Surgery Standardization (BMSS). A systematic review using PRISMA guidelines was performed on MEDLINE and EMBASE databases to identify video case reports (academic videos) and a similar search was performed on the commercial YouTube platform (commercial videos) simultaneously. All videos displaying LSG were reviewed and scored using the quality assessment tool. Academic and commercial videos were subsequently compared and an evidence-based checklist was created. RESULTS A total of 93 LSG recordings including 26 academic and 67 commercial videos were reviewed. Mean score of the checklist was 5/11 and 4/11 for videos published in articles and YouTube, respectively. Academic videos had higher rates of describing instruments used, such as orogastric tube (P < 0.001) and stapler information (P = 0.04). Fifty-four percent of academic videos described short-term patient outcomes, while not reported in commercial videos (P < 0.001). Sleeve resection status was not universally reported. CONCLUSIONS Videos published in the academic literature are describing steps in greater detail with more emphasis on specific technical elements and patient outcomes and thus have a higher educational value. A new quality assessment tool has been proposed for video reporting guidelines to improve the reliability and value of published video research.
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Affiliation(s)
- Laith Alghazawi
- Department of Surgery and Cancer, Imperial College London, London, UK.
| | - Michael G Fadel
- Department of Surgery and Cancer, Imperial College London, London, UK
- Department of Bariatric and Metabolic Surgery, Chelsea and Westminster Hospital, London, UK
| | - Jun Yu Chen
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Bibek Das
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Henry Robb
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Maria Rita Rodriguez-Luna
- Research Institute Against Digestive Cancer (IRCAD), Strasbourg, France
- ICube Laboratory, Photonics Instrumentation for Health, Strasbourg, France
| | - Naim Fakih-Gomez
- Department of Bariatric and Metabolic Surgery, Chelsea and Westminster Hospital, London, UK
| | - Silvana Perretta
- Research Institute Against Digestive Cancer (IRCAD), Strasbourg, France
- Department of Digestive and Endocrine Surgery, University of Strasbourg, Strasbourg, France
- IHU-Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
| | - Hutan Ashrafian
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Matyas Fehervari
- Department of Surgery and Cancer, Imperial College London, London, UK
- Gastrointestinal Surgery, Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells, UK
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Caputo V, Denoyelle F, Simon F. Educational endoscopic videos improve teaching of middle ear anatomy. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08658-1. [PMID: 38642088 DOI: 10.1007/s00405-024-08658-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 04/03/2024] [Indexed: 04/22/2024]
Abstract
PURPOSE Videos and images are becoming an educational tool in every domain. The objective was to assess the contribution of short educational endoscopic videos in learning the complex anatomy of the tympanic cavity. METHODS We conducted a prospective study amongst all the otolaryngology residents in 2021 in the greater Paris area (n = 74), from the first year to fifth year. We divided the residents into two groups who had the same 30-min anatomy class based on anatomical drawings. The second group had a 4-min endoscopic educational video at the end, whereas the first group did not. A video test of 10 surgical situations with each time 5 anatomic structures to identify was created. All the residents took the test just after the class, and 1 month later to assess long-term memory. The MERSQI score (design to assess the quality of educational studies) applied to our study was calculated. RESULTS The two groups were comparable in terms of training. The "video" group had significantly better results in the first test, mean score 24.40/50 (± 11.7) versus 16.74/50 (± 11.1) (p = 0.005) and also at 1 month, mean score 23.25/50 (± 12.3) versus 18.01/50 (± 11.3) (p = 0.035). The score in each group, and the difference between both groups, increased with resident seniority. The MERSQI score of our study was 14.5/18. CONCLUSION This study highlights the educational value of videos to help memorise complex 3D anatomy such as in the tympanic cavity.
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Lehmann T, Morgan E, Sharpe E, Steege J, Schroeder D, Dodd S. Managing the Lactating Patient Receiving Anesthesia: An Innovative Educational Initiative. J Womens Health (Larchmt) 2024. [PMID: 38634542 DOI: 10.1089/jwh.2023.0875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
Background: Breastfeeding has numerous health benefits for patients and their infants. There are inconsistencies in how anesthesia providers care for lactating patients undergoing anesthesia. Providers may be cautious and have patients "pump and dump" instead of following current evidence-based recommendations. Video-based education provides a novel reference for health care providers in their fast-paced work environments. This project evaluated the effectiveness of an online video module and resources accessed at the bedside for anesthesia providers caring for lactating patients. Materials and Methods: A preintervention survey was sent to anesthesia providers at a large academic institution to assess baseline knowledge of current recommendations for caring for lactating patients having anesthesia. A quick response code-linked video module and references were created and disseminated to all anesthesia providers. A postsurvey was sent to assess knowledge and satisfaction with the educational approach. Postsurvey data were compared with presurvey data. Results: All who watched the educational video found the education helpful to care for lactating patients undergoing surgery. In the posteducation group, 93% of providers selected the correct recommendation to continue breastfeeding or pumping after general anesthesia or sedation once the patient is awake and alert, compared with 48% in the pre-education group. After education, 92% would recommend preoperative feeding or pumping prior to transport to the operating room, compared with the 50% in the pre-education group. Conclusions: Video-based, just-in-time education is an effective way to deliver updated information to anesthesia providers. This format is conducive to just-in-time delivery, and there may be implications for other patient populations that present infrequently but require population-specific care.
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Affiliation(s)
- Taylor Lehmann
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Emily Morgan
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Emily Sharpe
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jenna Steege
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Darrell Schroeder
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | - Sarah Dodd
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Yiu A, Lam K, Simister C, Clarke J, Kinross J. Adoption of routine surgical video recording: a nationwide freedom of information act request across England and Wales. EClinicalMedicine 2024; 70:102545. [PMID: 38685926 PMCID: PMC11056472 DOI: 10.1016/j.eclinm.2024.102545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 05/02/2024] Open
Abstract
Background Surgical video contains data with significant potential to improve surgical outcome assessment, quality assurance, education, and research. Current utilisation of surgical video recording is unknown and related policies/governance structures are unclear. Methods A nationwide Freedom of Information (FOI) request concerning surgical video recording, technology, consent, access, and governance was sent to all acute National Health Service (NHS) trusts/boards in England/Wales between 20th February and 20th March 2023. Findings 140/144 (97.2%) trusts/boards in England/Wales responded to the FOI request. Surgical procedures were routinely recorded in 22 trusts/boards. The median estimate of consultant surgeons routinely recording their procedures was 20%. Surgical video was stored on internal systems (n = 27), third-party products (n = 29), and both (n = 9). 32/140 (22.9%) trusts/boards ask for consent to record procedures as part of routine care. Consent for recording included non-clinical purposes in 55/140 (39.3%) trusts/boards. Policies for surgeon/patient access to surgical video were available in 48/140 (34.3%) and 32/140 (22.9%) trusts/boards, respectively. Surgical video was used for non-clinical purposes in 64/140 (45.7%) trusts/boards. Governance policies covering surgical video recording, use, and/or storage were available from 59/140 (42.1%) trusts/boards. Interpretation There is significant heterogeneity in surgical video recording practices in England and Wales. A minority of trusts/boards routinely record surgical procedures, with large variation in recording/storage practices indicating scope for NHS-wide coordination. Revision of surgical video consent, accessibility, and governance policies should be prioritised by trusts/boards to protect key stakeholders. Increased availability of surgical video is essential for patients and surgeons to maximally benefit from the ongoing digital transformation of surgery. Funding KL is supported by an NIHR Academic Clinical Fellowship and acknowledges infrastructure support for this research from the National Institute for Health Research (NIHR) Imperial Biomedical Research Centre (BRC).
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Affiliation(s)
- Andrew Yiu
- Department of Surgery and Cancer, Imperial College London, UK
| | - Kyle Lam
- Department of Surgery and Cancer, Imperial College London, UK
| | | | - Jonathan Clarke
- Department of Surgery and Cancer, Imperial College London, UK
| | - James Kinross
- Department of Surgery and Cancer, Imperial College London, UK
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Brook K, Agarwala AV, Tewfik GL. Reframing the Morbidity and Mortality Conference: The Impact of a Just Culture. J Patient Saf 2024:01209203-990000000-00204. [PMID: 38470962 DOI: 10.1097/pts.0000000000001224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
ABSTRACT Morbidity and mortality (M&M) conferences are prevalent in all fields of medicine. Historically, they arose out a desire to improve medical care. Nevertheless, the goals of M&M conferences are often poorly defined, at odds with one another, and do not support a just culture. We differentiate among the various possible goals of an M&M and review the literature for strategies that have been shown to achieve these goals. Based on the literature, we outline an ideal M&M structure within the context of just culture: The process starts with robust adverse event and near miss reporting, followed by careful case selection, excluding cases solely attributable to individual error. Prior to the M&M, the case should be openly discussed with involved members and should be reviewed using a selected framework. The goal of the M&M should be selected and clearly defined, and the presentation format and rules of conduct should all conform to the selected presentation goal. The audience should ideally be multidisciplinary and multispecialty. The M&M should conclude with concrete tasks and assigned follow-up. The entire process should be conducted in a peer review protected format within an environment promoting psychological safety. We conclude with future directions for M&Ms.
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Affiliation(s)
| | - Aalok V Agarwala
- Department of Anaesthesia, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
| | - George L Tewfik
- Department of Anesthesiology, Rutgers-New Jersey Medical School, Newark, New Jersey
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Fassler CA, Langerman AJ. Invited Commentary: Using Surgical Recording to Assess Team Dynamics. J Am Coll Surg 2024; 238:216-217. [PMID: 37870225 DOI: 10.1097/xcs.0000000000000855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Axelsson CGS, Healy MG, Ramani S, Wolbrink T, Armstrong E, Phitayakorn R. Virtual training for small group facilitators. Clin Teach 2024:e13731. [PMID: 38273157 DOI: 10.1111/tct.13731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 12/20/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND In addition to providing patient care, interprofessional health care teams work collaboratively on a variety of projects. These projects often benefit from using facilitated small group project discussion sessions, such as the Harvard Macy Institute's (HMI) Step Back Process (SBP). Although having a trained facilitator is an important component of the SBP, only a limited number of health care professionals can attend HMI courses in person or virtually, limiting its impact. APPROACH We developed three video-based education (VBE) modules to deliver facilitator training on the SBP, informed by principles of Mayer's cognitive theory of multimedia learning. For module development, we used a five-step approach. We evaluated effectiveness of the modules as a self-directed method to enhance SBP facilitator training. An initial survey collected demographic data and module feedback, a follow-up survey collected feedback on the modules' impact on facilitation and interviews focused on the participants' overall experience. EVALUATION Survey results indicated that the modules were positively received and helped to improve participant confidence in facilitating. We identified four themes from the interviews: challenges of facilitating, value of group feedback, value of modules for experienced facilitators and the modules as part of a multi-modal approach to train new facilitators. IMPLICATIONS This innovation provides insight on delivering facilitator training on the SBP using VBE. Health professions educators developing online facilitator training could adapt our development process and modify implementation guided by our results. Future work should evaluate the best methods to integrate VBE modules into a longitudinal virtual community and assess facilitation techniques.
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Affiliation(s)
| | - Michael G Healy
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Subha Ramani
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Traci Wolbrink
- Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Roy Phitayakorn
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Yánez Benítez C, Ottolino Lavarte P, Richard L, Ivatury R, Ferrada R, Borráez O, Turegano F, Puyana JC, Aranda J, Pareja F, Peralta R, Rodríguez A. Innovation in surgical trauma care education: assessment of a Panamerican Trauma Society online surgical skills course hosted by the Spanish Surgical Association. Eur J Trauma Emerg Surg 2024:10.1007/s00068-023-02431-5. [PMID: 38216674 DOI: 10.1007/s00068-023-02431-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/28/2023] [Indexed: 01/14/2024]
Abstract
PURPOSE Incorporating surgical skills education in trauma care is essential for young surgeons and surgical trainees. This study describes an innovative e-learning course for teaching trauma care surgical skills in an international cooperative setting. Furthermore, it aims to offer valuable insights on enhancing e-learning practices. METHODS The Panamerican Trauma Society and the Spanish Surgical Association have joined forces to launch an online course focusing on advanced trauma care surgical skills. This report provides an in-depth examination of the project and scrutinizes participant feedback through a post-course survey. The survey thoroughly evaluates their satisfaction level, the usefulness of the course content, and their view on its clinical relevance. RESULTS Three hundred eighty-two surgeons from 16 countries completed an online course. Three hundred seventy-nine of them responded to the post-course survey. The mean age was 36, with 64% females and 36% males. The course consisted of 9.9 h of academic content, including 5 h of video lectures and 4.9 h of live discussions. Ninety-seven percent of the participants were practicing general and acute care surgeons, and only 2% were exclusively dedicated to trauma surgery. Sixty-one percent of participants highly valued real-time interaction with faculty, and 95% believed their trauma surgical skills would improve. Additionally, 93% of the participants were satisfied or very satisfied with the e-learning experience. CONCLUSIONS The use of video-based instructional materials has revolutionized surgical education. With online courses in trauma surgery, surgeons can now improve their skills and better prepare themselves to handle severe trauma cases. This innovative approach to surgical education has proven to be very effective and can potentially enhance patients' quality of care.
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Affiliation(s)
- Carlos Yánez Benítez
- Department of General Surgery, San Jorge University Hospital, SALUD, Ave. Martínez de Velasco, 36, 22004, Huesca, Spain.
| | | | - Luis Richard
- Faculty of Medicine, Department of General Surgery, Universidad Autónoma de Centro, Domingo Luciani Hospital, Caracas, Venezuela
| | - Rao Ivatury
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
- Division of Trauma, Critical Care and Emergency General Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA
| | | | - Oswaldo Borráez
- Department of General Surgery, San Blas Hospital, Bogotá, Colombia
| | - Fernando Turegano
- Department of General Surgery, Emergency Surgery Section, Gregorio Marañón Hospital, Madrid, Spain
| | | | - José Aranda
- Department of General Surgery, Emergency Surgery Section, Carlos Haya University Hospital, Málaga, Spain
| | - Felipe Pareja
- Department of General Surgery, Emergency Surgery Section, Virgen del Rocio University Hospital, Seville, Spain
| | - Rubén Peralta
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Aurelio Rodríguez
- University of Maryland, College Park, USA
- Drexel University College of Medicine, Philadelphia, USA
- R Adams Cowley Shock Trauma Center, Baltimore, USA
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Abstract
BACKGROUND The COVID-19 pandemic has disrupted components of traditional education with shifts toward virtual platforms. This report describes the virtual approach to basic surgical skills training during a high school program in the summers of 2020 and 2021. METHODS Two 2-week sessions were held by Zoom (Zoom Video Communications) with 99 students in 2020 and 198 students in 2021. Each student was sent surgical supplies and instruments. Interactive lectures were held each morning, and basic surgical skills instruction was provided each afternoon. After the session, survey links were distributed to students to complete an anonymous 37-item questionnaire regarding surgical skills confidence, simulation kit satisfaction, and technical difficulties. RESULTS Of the 297 students, 270 (90.9%) completed the questionnaire, including 91 (91.9%) in 2020 and 179 (90.4%) in 2021. On a scale of 1 (fair) to 5 (excellent), students in 2020 and 2021 reported similar confidence in instrument handling (4-5: 90.0% vs 86.3%; P = .38), suturing skin (4-5: 88.9% vs 82.8%; P = .19), and thoracic aorta suturing (4-5: 73.3% vs 73.6%; P = .97). Students reported greater confidence in 2020 in knot tying (4-5: 98.9% vs 87.9%; P = .002), coronary vessel suturing (4-5: 82.2% vs 65.5%; P < .001), and valve model suturing (4-5: 68.5% vs 50.3%; P = .005) than students in 2021. Students had similar satisfaction rates with the program (extremely or somewhat satisfied: 92.3% vs 86.0%; p = .51) between 2020 and 2021. CONCLUSIONS Virtual education carries the potential for basic surgical skills training for a more widespread audience with less access to direct surgical education. Further research is needed to optimize teaching finer surgical skills.
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Affiliation(s)
- Simar Singh Bajaj
- Department of Cardiothoracic Surgery, Stanford University, Stanford, California
| | - Hiteshi H Patel
- Department of Cardiothoracic Surgery, Stanford University, Stanford, California
| | - James I Fann
- Department of Cardiothoracic Surgery, Stanford University, Stanford, California
| | - Michael Ma
- Department of Cardiothoracic Surgery, Stanford University, Stanford, California
| | - Natalie S Lui
- Department of Cardiothoracic Surgery, Stanford University, Stanford, California.
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Muehlberg J, Tipold A, Heppelmann M, Wissing S. Simulator-Assisted Training of Abomasal Surgery-A Pilot Study Using Blended Learning and Face-to-Face Teaching. Animals (Basel) 2023; 13:3822. [PMID: 38136859 PMCID: PMC10740769 DOI: 10.3390/ani13243822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Two stimulators were developed, one simplified and one realistic, in the present study for learning abomasal surgery for veterinary students. The simulators were tested in a pilot study: The upcoming blended learning format was compared with traditional face-to-face teaching. A total of 21 5th-year students participated in the study. While one group learned the surgical technique in traditional face-to-face simulator training, the second group completed interactive video training asynchronously. Afterwards, skills were examined in person. The results showed that the different groups did not lead to different performance results. Participation in the study increased self-assessment of skills by an average of about 7 of 36 points, as well as the learning success and motivation of students in both groups. The simulators developed were well liked by the students and rated as appropriate by 12 practicing bovine veterinarians. The pilot study indicates that blended learning could be a suitable alternative to traditional face-to-face teaching. This should be followed by further research to support the use of blended learning in the veterinary education of clinical skills.
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Affiliation(s)
- Julia Muehlberg
- Clinical Skills Lab, Centre for E-Learning, Didactics and Training Research, University of Veterinary Medicine Hannover, 30173 Hannover, Germany;
| | - Andrea Tipold
- Clinic for Small Animals, Neurology, University of Veterinary Medicine Hannover, 30559 Hannover, Germany;
| | - Maike Heppelmann
- Clinic for Cattle, University of Veterinary Medicine Hannover, 30173 Hannover, Germany;
| | - Sandra Wissing
- Clinical Skills Lab, Centre for E-Learning, Didactics and Training Research, University of Veterinary Medicine Hannover, 30173 Hannover, Germany;
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Feenstra TM, van der Storm SL, Barsom EZ, Bonjer JH, Nieveen van Dijkum EJ, Schijven MP. Which, how, and what? Using digital tools to train surgical skills; a systematic review and meta-analysis. Surg Open Sci 2023; 16:100-110. [PMID: 37830074 PMCID: PMC10565595 DOI: 10.1016/j.sopen.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/02/2023] [Indexed: 10/14/2023] Open
Abstract
Background Digital tools like digital box trainers and VR seem promising in delivering safe and tailored practice opportunities outside of the surgical clinic, yet understanding their efficacy and limitations is essential. This study investigated Which digital tools are available to train surgical skills, How these tools are used, How effective they are, and What skills they are intended to teach. Methods Medline, Embase, and Cochrane libraries were systematically reviewed for randomized trials, evaluating digital skill-training tools based on objective outcomes (skills scores and completion time) in surgical residents. Digital tools effectiveness were compared against controls, wet/dry lab training, and other digital tools. Tool and training factors subgroups were analysed, and studies were assessed on their primary outcomes: technical and/or non-technical. Results The 33 included studies involved 927 residents and six digital tools; digital box trainers, (immersive) virtual reality (VR) trainers, robot surgery trainers, coaching and feedback, and serious games. Digital tools outperformed controls in skill scores (SMD 1.66 [1.06, 2.25], P < 0.00001, I2 = 83 %) and completion time (SMD -1.05 [-1.72, -0.38], P = 0.0001, I2 = 71 %). There were no significant differences between digital tools and lab training, between tools, or in other subgroups. Only two studies focussed on non-technical skills. Conclusion While the efficacy of digital tools in enhancing technical surgical skills is evident - especially for VR-trainers -, there is a lack of evidence regarding non-technical skills, and need to improve methodological robustness of research on new (digital) tools before they are implemented in curricula. Key message This study provides critical insight into the increasing presence of digital tools in surgical training, demonstrating their usefulness while identifying current challenges, especially regarding methodological robustness and inattention to non-technical skills.
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Affiliation(s)
- Tim M. Feenstra
- Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, the Netherlands
- Amsterdam Public Health, Digital Health, Amsterdam, the Netherlands
| | - Sebastiaan L. van der Storm
- Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, the Netherlands
- Amsterdam Public Health, Digital Health, Amsterdam, the Netherlands
| | - Esther Z. Barsom
- Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, the Netherlands
| | - Jaap H. Bonjer
- Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Cancer Centre Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Els J.M. Nieveen van Dijkum
- Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, the Netherlands
- Amsterdam institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Marlies P. Schijven
- Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, the Netherlands
- Amsterdam Public Health, Digital Health, Amsterdam, the Netherlands
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14
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Ortenzi M, Rapoport Ferman J, Antolin A, Bar O, Zohar M, Perry O, Asselmann D, Wolf T. A novel high accuracy model for automatic surgical workflow recognition using artificial intelligence in laparoscopic totally extraperitoneal inguinal hernia repair (TEP). Surg Endosc 2023; 37:8818-8828. [PMID: 37626236 PMCID: PMC10615930 DOI: 10.1007/s00464-023-10375-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/30/2023] [Indexed: 08/27/2023]
Abstract
INTRODUCTION Artificial intelligence and computer vision are revolutionizing the way we perceive video analysis in minimally invasive surgery. This emerging technology has increasingly been leveraged successfully for video segmentation, documentation, education, and formative assessment. New, sophisticated platforms allow pre-determined segments chosen by surgeons to be automatically presented without the need to review entire videos. This study aimed to validate and demonstrate the accuracy of the first reported AI-based computer vision algorithm that automatically recognizes surgical steps in videos of totally extraperitoneal (TEP) inguinal hernia repair. METHODS Videos of TEP procedures were manually labeled by a team of annotators trained to identify and label surgical workflow according to six major steps. For bilateral hernias, an additional change of focus step was also included. The videos were then used to train a computer vision AI algorithm. Performance accuracy was assessed in comparison to the manual annotations. RESULTS A total of 619 full-length TEP videos were analyzed: 371 were used to train the model, 93 for internal validation, and the remaining 155 as a test set to evaluate algorithm accuracy. The overall accuracy for the complete procedure was 88.8%. Per-step accuracy reached the highest value for the hernia sac reduction step (94.3%) and the lowest for the preperitoneal dissection step (72.2%). CONCLUSIONS These results indicate that the novel AI model was able to provide fully automated video analysis with a high accuracy level. High-accuracy models leveraging AI to enable automation of surgical video analysis allow us to identify and monitor surgical performance, providing mathematical metrics that can be stored, evaluated, and compared. As such, the proposed model is capable of enabling data-driven insights to improve surgical quality and demonstrate best practices in TEP procedures.
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Affiliation(s)
- Monica Ortenzi
- Theator Inc., Palo Alto, CA, USA.
- Department of General and Emergency Surgery, Polytechnic University of Marche, Ancona, Italy.
| | | | | | - Omri Bar
- Theator Inc., Palo Alto, CA, USA
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15
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Nau P, Worden E, Lehmann R, Kleppe K, Mancini GJ, Mancini ML, Ramshaw B, Woods MS. Using video-based assessment (VBA) to document fellow improvement in safely completing the jejunojejunostomy portion of laparoscopic Roux-en-Y gastric bypass (RYGB) surgery. Surg Endosc 2023; 37:8853-8860. [PMID: 37759145 DOI: 10.1007/s00464-023-10425-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Surgical assessment instruments are used for formative and summative trainee evaluations. To characterize the features of existing instruments and a novel 12-item objective, procedure-specific assessment tool for Roux-en-Y Gastric Bypass (RYGB-OPSA), we evaluated the progress of a single surgical fellow over 17 consecutive surgeries. METHODS Seventeen consecutive RYGB videos completed between 8/2021 and 1/2022 by an academic hospital surgical fellow were de-identified and assessed by four board-certified bariatric surgeons using Global Operative Assessment of Laparoscopic Skills (GOALS), General Assessment of Surgical Skill (GASS), and RYGB-OPSA which includes the reflection of transverse colon, identification of ligament of Treitz, biliopancreatic and Roux limbs orientation, jejunal division point selection, stapler use, mesentery division, bleeding control, jejunojejunostomy (JJ) anastomotic site selection, apposition of JJ anastomotic site, JJ creation, common enterotomy closure of JJ, and integrity of anastomosis. The GASS measured economy of motion, tissue handling, appreciating operative anatomy, bimanual dexterity, and achievement of hemostasis. RYGB-OPSA and GASS items were scored "poor-unsafe," "acceptable-safe," or "good-safe." Change in performance was measured by linear trendline slope. RESULTS Over the course of 17 procedures, significant improvement was demonstrated by three GOALS items, GOALS overall score, GASS bimanual dexterity, and three RYGB-OPSA tasks: JJ creation, jejunal division point selection, and stapler use. Achievement of hemostasis declined but never rated "poor-unsafe." Overall RYGB-OPSA and GOALS trendlines documented significant increase across the 17 procedures. CONCLUSION This examination of a bariatric surgery fellow's operative training experience as measured by three surgical assessment instruments demonstrated anticipated improvements in general skills and safe completion of procedure-specific tasks. Effective surgical assessment instruments have enough sensitivity to show improvement to enable meaningful trainee feedback (low-stakes assessments) as well as the ability to determine safe surgical practice to enable promotion to greater autonomous practice.
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Affiliation(s)
- Peter Nau
- Section of Bariatric Surgery, Department of Surgery, University of Iowa Hospitals & Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
| | - Erin Worden
- Section of Bariatric Surgery, Department of Surgery, University of Iowa Hospitals & Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Ryan Lehmann
- Section of Bariatric Surgery, Department of Surgery, University of Iowa Hospitals & Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Kyle Kleppe
- Section of Foregut Surgery, Department of Surgery, University of Tennessee - Knoxville, 1924 Alcoa Highway, Knoxville, TN, 37920, USA
| | - Gregory J Mancini
- Section of Foregut Surgery, Department of Surgery, University of Tennessee - Knoxville, 1924 Alcoa Highway, Knoxville, TN, 37920, USA
| | - Matt L Mancini
- Section of Foregut Surgery, Department of Surgery, University of Tennessee - Knoxville, 1924 Alcoa Highway, Knoxville, TN, 37920, USA
| | - Bruce Ramshaw
- CQInsights PBC, Knoxville, TN, USA
- Caresyntax Corporation, Boston, MA, USA
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16
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Motonaga KS, Sacks L, Olson I, Balasubramanian S, Chen S, Peng L, Feinstein JA, Silverman NH, Hanley FL, Axelrod DM, Krawczeski CD, Arunamata A, Kwiatkowski DM, Ceresnak SR. The development and efficacy of a paediatric cardiology fellowship online preparatory course. Cardiol Young 2023; 33:1975-1980. [PMID: 36440543 DOI: 10.1017/s1047951122003626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The transition from residency to paediatric cardiology fellowship is challenging due to the new knowledge and technical skills required. Online learning can be an effective didactic modality that can be widely accessed by trainees. We sought to evaluate the effectiveness of a paediatric cardiology Fellowship Online Preparatory Course prior to the start of fellowship. METHODS The Online Preparatory Course contained 18 online learning modules covering basic concepts in anatomy, auscultation, echocardiography, catheterisation, cardiovascular intensive care, electrophysiology, pulmonary hypertension, heart failure, and cardiac surgery. Each online learning module included an instructional video with pre-and post-video tests. Participants completed pre- and post-Online Preparatory Course knowledge-based exams and surveys. Pre- and post-Online Preparatory Course survey and knowledge-based examination results were compared via Wilcoxon sign and paired t-tests. RESULTS 151 incoming paediatric cardiology fellows from programmes across the USA participated in the 3 months prior to starting fellowship training between 2017 and 2019. There was significant improvement between pre- and post-video test scores for all 18 online learning modules. There was also significant improvement between pre- and post-Online Preparatory Course exam scores (PRE 43.6 ± 11% versus POST 60.3 ± 10%, p < 0.001). Comparing pre- and post-Online Preparatory Course surveys, there was a statistically significant improvement in the participants' comfort level in 35 of 36 (97%) assessment areas. Nearly all participants (98%) agreed or strongly agreed that the Online Preparatory Course was a valuable learning experience and helped alleviate some anxieties (77% agreed or strongly agreed) related to starting fellowship. CONCLUSION An Online Preparatory Course prior to starting fellowship can provide a foundation of knowledge, decrease anxiety, and serve as an effective educational springboard for paediatric cardiology fellows.
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Affiliation(s)
- Kara S Motonaga
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford University, Palo Alto, CA, USA
| | - Loren Sacks
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford University, Palo Alto, CA, USA
| | - Inger Olson
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford University, Palo Alto, CA, USA
| | - Sowmya Balasubramanian
- Department of Pediatrics, Division of Pediatric Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Sharon Chen
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford University, Palo Alto, CA, USA
| | - Lynn Peng
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford University, Palo Alto, CA, USA
| | - Jeffrey A Feinstein
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford University, Palo Alto, CA, USA
| | - Norman H Silverman
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford University, Palo Alto, CA, USA
| | - Frank L Hanley
- Department of Cardiothoracic Surgery, Division of Pediatric Cardiac Surgery, Stanford University, Palo Alto, CA, USA
| | - David M Axelrod
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford University, Palo Alto, CA, USA
| | - Catherine D Krawczeski
- Department of Pediatrics, Division of Pediatric Cardiology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Alisa Arunamata
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford University, Palo Alto, CA, USA
| | - David M Kwiatkowski
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford University, Palo Alto, CA, USA
| | - Scott R Ceresnak
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford University, Palo Alto, CA, USA
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17
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Mayer M, Isik TB, Nachtsheim L, Wolber P, Hansen KK, Grosheva M, Klussmann JP, Shabli S. Analysis of the Quality of Parotidectomy Videos on YouTube Using the IVORY-Grading-System. Laryngoscope 2023; 133:2631-2637. [PMID: 36734324 DOI: 10.1002/lary.30593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/23/2022] [Accepted: 01/17/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the quality and the educational content of YouTube videos showing parotidectomy. METHODS We searched for videos displaying parotidectomy on YouTube. To rate parotidectomy videos, we introduced the "Instructional Videos in Otorhinolaryngology by YO-IFOS (IVORY)-grading-system (GS)" derived from the IVORY Guidelines, which pose established consensus recommendations for the production of educational surgical videos in otolaryngology. The videos were rated using the IVORY-GS, and the total score was tested for statistical association with views, likes, likes/dislikes-ratio, age, and length of the videos for validation of the IVORY-GS. RESULTS Overall, 50 parotidectomy videos were identified. Sixty-eight (68%) of the videos showed a superficial parotidectomy. The mean IVORY-GS total score was 24.9 (out of a maximum of 44 points). Video education quality was rated as moderate in 22% and high in 4%. There was a statistically significant correlation between the total score and the number of views (p = 0.03), the total score and the number of likes (p < 0.01), and the total score and the likes/dislikes ratio (p < 0.01). A higher total score was a significant predictor of more likes (p = 0.01) and a higher likes/dislikes ratio (p < 0.01). CONCLUSION Our modification of the IVORY Guidelines is otolaryngology-specific, suitable, and recommended to evaluate parotidectomy videos. To date, most videos are of poor educational quality. Future efforts in otolaryngology surgical video education could focus on the establishment of an online video platform. LEVEL OF EVIDENCE NA Laryngoscope, 133:2631-2637, 2023.
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Affiliation(s)
- Marcel Mayer
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Tarik B Isik
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Lisa Nachtsheim
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Philipp Wolber
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Kevin K Hansen
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Maria Grosheva
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Jens P Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Sami Shabli
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
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18
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Gomindes AR, Adeeko ES, Khatri C, Ahmed I, Sehdev S, Carlos WJ, Ward T, Leverington J, Debenham L, Metcalfe A, Ward J. Use of Virtual Reality in the Education of Orthopaedic Procedures: A Randomised Control Study in Early Validation of a Novel Virtual Reality Simulator. Cureus 2023; 15:e45943. [PMID: 37885489 PMCID: PMC10599600 DOI: 10.7759/cureus.45943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
Background Virtual reality (VR) simulation is a potential solution to the barriers surgical trainees are facing. There needs to be validation for its implementation within current training. We aimed to compare VR simulation to traditional methods in acquiring surgical skills for a TFN-ADVANCED™ Proximal Femoral Nailing System (TFNA; DePuy Synthes, Auckland, New Zealand) femoral nailing system. Methods Thirty-one surgical trainees were randomised to two groups: traditional-training group (control group) and a VR-training group (intervention group) for insertion of a short cephalomedullary TFNA nail. Both groups then inserted the same TFNA system into saw-bone femurs. Surveys evaluated validity of the relevant activities, perception of simulation, confidence, stress and anxiety. The primary outcomes were tip-apex distance (TAD) and user anxiety/confidence levels. Secondary outcomes included number of screw- and nail-guidewire insertion attempts, the time taken to complete and user validity of the VR system. Results There was no statistical difference in TAD between the intervention and control groups (9mm vs 15mm, p=0.0734). The only TAD at risk of cut-out was in the control group (25mm). There was no statistical difference in time taken (2547.5ss vs 2395ss, p=0.668), nail guide-wire attempts (two for both groups, p=0.355) and screw guide-wire attempts (one for both groups, p=0.702). The control group versus intervention had higher anxiety levels (50% vs 33%) and had lower confidence (61% vs 84%). Interpretation There was no objective difference in performance on a saw-bone model between groups. However, this VR simulator resulted in more confidence and lower anxiety levels whilst performing a simulated TFNA. Whilst further studies with larger sample sizes and exploration of transfer validity to the operating theatre are required, this study does indicate potential benefits of VR within surgical training.
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Affiliation(s)
- Austin R Gomindes
- School of Medical and Dental Sciences, University of Birmingham, Birmingham, GBR
- Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire, Coventry, GBR
| | | | - Chetan Khatri
- Trauma and Orthopaedics, University of Warwick, Warwick, GBR
- Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire, Coventry, GBR
| | - Imran Ahmed
- Trauma and Orthopaedics, University of Warwick, Warwick, GBR
- Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire, Coventry, GBR
| | - Simran Sehdev
- Trauma and Orthopaedics, University of Warwick, Warwick, GBR
| | - William John Carlos
- Trauma and Orthopaedics, University of Warwick, Warwick, GBR
- Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire, Coventry, GBR
| | - Thomas Ward
- Trauma and Orthopaedics, University of Warwick, Warwick, GBR
- Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire, Coventry, GBR
| | - James Leverington
- Trauma and Orthopaedics, University of Warwick, Warwick, GBR
- Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire, Coventry, GBR
| | - Luke Debenham
- Trauma and Orthopaedics, University of Warwick, Warwick, GBR
- Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire, Coventry, GBR
| | - Andrew Metcalfe
- Trauma and Orthopaedics, University of Warwick, Warwick, GBR
| | - Jayne Ward
- Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire, Coventry, GBR
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19
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Ozturk E, Kuzu MA. The Impact of E-learning on Colorectal Surgery Training. Colorectal Dis 2023; 25:1571. [PMID: 37583348 DOI: 10.1111/codi.16700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Affiliation(s)
- Ersin Ozturk
- Department of Surgery, Ankara University, Ankara, Turkey
| | - M Ayhan Kuzu
- Department of Surgery, Ankara University, Ankara, Turkey
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20
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Guo J, Guo Q, Feng M, Liu S, Li W, Chen Y, Zou J. The use of 3D video in medical education: A scoping review. Int J Nurs Sci 2023; 10:414-421. [PMID: 37545776 PMCID: PMC10401357 DOI: 10.1016/j.ijnss.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 06/01/2023] [Accepted: 06/19/2023] [Indexed: 08/08/2023] Open
Abstract
Objectives The use of 3D video in medical education has not been fully explored. This article aims to review the evidence on 3D video currently presented in the medical education literature, including its impact on curriculum activities, to reference future research in this field. Methods According to the guidelines of Arksey and O'Malley, the authors used a systematic search strategy (the last search was in December 2022) to search nine literature databases published in English, and only primary studies were included. Two authors independently screened all articles based on the eligibility criteria and performed a thematic analysis of the included literature. Results Of 1,302 articles identified, 23 were included for insights into how opportunities for 3D video in medical education are created, how they are experienced, and how they influence and manifest behavior demonstrated partial congruency. Three themes were identified: (a) advantages of using 3D video in medical education; (b) the effect of using 3D video in medical education on students' academic achievement and ability; and (c) students' experience of 3D video in medical education. Conclusions The application of 3D video in medical education has won the support of most students and educators. However, the effect of using 3D video in medical education is still controversial. Medical educators should combine the curriculum's characteristics, the students' learning situation, and the existing educational resources and choose to use them after careful consideration.
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Affiliation(s)
- Juan Guo
- Sichuan Vocational College of Health and Rehabilitation, Zigong, China
- West China Hospital, Sichuan University, Chengdu, China
| | - Qingmin Guo
- Southwest Petroleum University, Chengdu, China
| | - Mei Feng
- West China Hospital, Sichuan University, Chengdu, China
| | - Shanshan Liu
- West China Hospital, Sichuan University, Chengdu, China
| | - Wenping Li
- Sichuan Vocational College of Health and Rehabilitation, Zigong, China
| | - Yuzhen Chen
- West China Hospital, Sichuan University, Chengdu, China
| | - Jinmei Zou
- Sichuan Vocational College of Health and Rehabilitation, Zigong, China
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21
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Brown KE, Flores MJ, MacKechnie MC, Rodarte P, O'Marr J, Shearer DW, Toogood P. Novel e-learning platform for orthopaedic training in LMICs: A descriptive review of the IGOT portal. Surg Open Sci 2023; 13:24-26. [PMID: 37351189 PMCID: PMC10282557 DOI: 10.1016/j.sopen.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 04/08/2023] [Indexed: 06/24/2023] Open
Abstract
Background While e-learning has been written about extensively within the context of orthopaedics in the United States, there are few articles describing e-learning initiatives geared towards low-and middle-income countries (LMICs). The Institute for Global Orthopaedics and Traumatology (IGOT) at the University of California, San Francisco (UCSF) developed the IGOT Learning Portal to meet this need. Methods The IGOT Learning Portal was designed to address knowledge gaps in patient care by increasing access to high-quality orthopaedic education for surgeons and trainees worldwide. It offers 10 distinct, asynchronous courses, which are divided into a modular format. Course enrollment is free and accessible to any surgeon or trainee with a web-browsing capable device and internet connection. Results There are more than 2700 registered users and 300 active learners enrolled in IGOT Learning Portal courses. The Surgical Management and Reconstructive Training (SMART) program is the most commonly taken course. Learners represent 32 different countries across six continents. The IGOT portal also has surgical videos available on YouTube. The IGOT Portal YouTube channel has over 2000 subscribers and over 143,000 total views. Conclusions The IGOT Learning Portal is an innovative approach to address the global disparity in orthopaedic trauma care by improving access to high-quality surgical education for surgeons and trainees both in the US and internationally. The development of an interactive online forum may be a beneficial addition to the Portal. Future directions include assessing content retention, participant interaction, and expanding existing content to other orthopaedic subspecialties.
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Affiliation(s)
| | | | | | | | | | | | - Paul Toogood
- Corresponding author at: 2550 23rd Street, San Francisco, CA 94110, USA.
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22
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Larkins K, Mohamed JE, Mohan H, Heriot A, Warrier S. How I Do It: Structured Narration for Cognitive Simulation-based Training in Robotic Surgery. J Surg Educ 2023; 80:624-628. [PMID: 36890046 DOI: 10.1016/j.jsurg.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/05/2022] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
Video in robotic surgical education is an important and effective training tool. The educational benefit of video training tools can be enhanced by incorporating cognitive simulation using mental imagery. Narration of robotic surgical training video is an under-explored aspect of video design. Narration can be structured to stimulate visualization and procedural mental mapping. To achieve this, narration should be constructed to follow operative phases and steps and include the procedural, technical and cognitive components. This approach provides a foundation for building an understanding of the key concepts required to safely complete a procedure.
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Affiliation(s)
- Kirsten Larkins
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
| | - Jade El Mohamed
- International Medical Robotics Academy, North Melbourne, Victoria, Australia
| | - Helen Mohan
- Austin Health, Heidelberg, Victoria, Australia
| | - Alexander Heriot
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; International Medical Robotics Academy, North Melbourne, Victoria, Australia
| | - Satish Warrier
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; International Medical Robotics Academy, North Melbourne, Victoria, Australia; Department of Surgery, Monash University, Victoria, Australia
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Abstract
BACKGROUND Educational videos are a potent resource for the learning of surgical skills among different study cohorts. However, there is limited evidence on the effectiveness of different educational video interventions and their features. UNLABELLED A systematic search of MEDLINE (via PubMed), Embase (via OVID), Cochrane libraries and Clinicaltrials.gov was performed from inception to 28/02/21. Studies included were not limited by date of publication, studies aiming to assess the impact of video-based interventions in the direct acquisition of surgical skill were included. Eligible studies were analysed based on study type, type of video intervention, method of assessment and period of education. The educational impact of the studies was also assessed as per Messick's framework for testing validity of evaluation methods and McGhagie's model for analysing translational outcomes. UNLABELLED 22 studies were deemed suitable for inclusion, of which 14/22 (63.6%) demonstrated a significant improvement in knowledge/skills following the video-based teaching interventions, 3/22 (13.6%) studies demonstrated an improvement in trainee satisfaction scores. A recurrent limitation of the included studies was the lack of validation of selected assessment methods. None of the included studies scored on all 5 parameters of validity as defined by Messicks validity framework. Furthermore, none of the included trials were conducted for long enough to indicate direct changes to patient outcomes resultant from educational methods. CONCLUSION Video-based surgical education is effective in learning surgical skills within different levels of surgical training; however, superior study quality and follow-up is required to determine which aspects of video-based interventions are most impactful.
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Affiliation(s)
- Samy Cheikh Youssef
- Guy’s, King’s and St Thomas’ School
of Medical Education, King’s College London, London, UK
| | - Abdullatif Aydin
- Guy’s Hospital, King’s College
London, MRC Centre for
Transplantation, London, UK
| | - Alexander Canning
- Guy’s, King’s and St Thomas’ School
of Medical Education, King’s College London, London, UK
| | - Nawal Khan
- Department of Urology, The London Clinic, London, UK
| | - Kamran Ahmed
- Guy’s Hospital, King’s College
London, MRC Centre for
Transplantation, London, UK
| | - Prokar Dasgupta
- Guy’s Hospital, King’s College
London, MRC Centre for
Transplantation, London, UK
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Campbell BR, Esianor BI, Barrett TW, Casey JD, Steitz B, Du L, Gelbard A. Association of Educational Intervention With Knowledge of Airway Injury After Endotracheal Intubation and Tube Size Selection. JAMA Otolaryngol Head Neck Surg 2023; 149:372-374. [PMID: 36821123 PMCID: PMC9951102 DOI: 10.1001/jamaoto.2022.5099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/28/2022] [Indexed: 02/24/2023]
Abstract
In this nonrandomized controlled trial, an educational intervention for emergency medicine residents was developed to increase knowledge of airway injury following prolonged intubation and reduce the proportion of large-for-height endotracheal tubes placed in the emergency department.
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Affiliation(s)
- Benjamin R. Campbell
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Brandon I. Esianor
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Tyler W. Barrett
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jonathan D. Casey
- Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Bryan Steitz
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Liping Du
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Alexander Gelbard
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
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Hughes Née Richardson B, Benoit B, Rutledge K, Dol J, Martin-Misener R, Latimer M, Smit M, McGrath P, Campbell-Yeo M. Impact of parent-targeted eHealth educational interventions on infant procedural pain management: a systematic review. JBI Evid Synth 2023; 21:669-712. [PMID: 36591975 DOI: 10.11124/jbies-21-00435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The objective of this review was to determine whether electronic health (eHealth) educational interventions about infant procedural pain and pain management impact parental outcomes (eg, mental health, knowledge uptake), eHealth outcomes (eg, acceptance, use), and pain management outcomes (eg, parental involvement, infant pain response). INTRODUCTION Pain in infants is a common concern for parents. Routine postpartum care for infants in early life requires them to endure painful procedures, such as immunizations, yet infants often receive little to no pain management. Parents are an essential component of effective pain management, although they may not be aware of the roles they play. Despite the increased number of eHealth resources available to educate parents about infant pain management, their impact has yet to be synthesized. INCLUSION CRITERIA This review considered studies that evaluated eHealth educational interventions targeted at parents during pregnancy and up to 1 year postpartum. Interventions included, but were not limited to, mobile applications, web-based applications, websites, videos, interactive training, hands-on direct simulation, short message service (SMS), and desktop applications. Primary outcomes included parental outcomes (eg, stress or anxiety, self-efficacy, knowledge, attitudes), eHealth outcomes (eg, acceptance, use), and pain management outcomes (eg, parental involvement, infant pain response). Experimental, quasi-experimental, and observational study designs were included. METHODS MEDLINE, CINAHL, PsycINFO, Embase, Scopus, Web of Science, and SciELO were searched for studies published in English up to June 14, 2021. Citation lists of relevant reviews and included studies were also searched for additional peer-reviewed articles. Two independent reviewers conducted critical appraisal using standardized tools from JBI, and data extraction, using a data extraction form designed by the authors. Statistical pooling of quantitative data was not possible due to heterogeneity; thus, the findings were reported narratively. RESULTS A total of 4163 unique studies were screened, with 11 studies ultimately included for synthesis. Five articles were randomized controlled trials, 5 articles were analytical cross-sectional studies, and 1 article was quasi-experimental. Studies reported on 4 unique eHealth educational interventions, all of which used video format and primarily targeted the postnatal period. The findings for all primary outcomes were mixed but suggested either improvements in outcomes or no impact. The certainty of evidence was determined as low or very low across primary outcomes for reasons related to imprecision, risk of bias, and indirectness. CONCLUSIONS Although heterogeneity of findings limited quantitative synthesis of data, this review suggests that short and engaging educational videos have the potential to positively impact parents' knowledge, confidence, and desire to be involved in procedural pain management for their children. Most of the interventions presented in this review describe evidence-based information about procedural pain management strategies that are known to be effective for infant populations. Thus, it is reasonable to assume that infant pain response should be lower when parents appropriately apply the strategies. However, the findings of this review were not able to confirm this assumption. More research is needed to evaluate the impact of parent-targeted pain management education on infant pain response. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020151569.
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Affiliation(s)
- Brianna Hughes Née Richardson
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change: A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- Centre for Transformative Nursing and Health Research, Halifax, NS, Canada
| | - Britney Benoit
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change: A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- Centre for Transformative Nursing and Health Research, Halifax, NS, Canada
- Elizabeth and Thomas Rankin School of Nursing, St. Francis Xavier University, NS, Antigonish, Canada
| | - Kallen Rutledge
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
| | - Justine Dol
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change: A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- The Mothering Transitions Research Lab, St. Michael's Hospital, Toronto, ON, Canada
| | - Ruth Martin-Misener
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change: A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- Centre for Transformative Nursing and Health Research, Halifax, NS, Canada
| | - Margot Latimer
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change: A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- Centre for Transformative Nursing and Health Research, Halifax, NS, Canada
| | - Michael Smit
- School of Information Management, Dalhousie University, Halifax, NS, Canada
| | - Patrick McGrath
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Marsha Campbell-Yeo
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change: A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
- Centre for Transformative Nursing and Health Research, Halifax, NS, Canada
- Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, NS, Canada
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Takagi K, Hata N, Kimura J, Kikuchi S, Noma K, Yasui K, Fuji T, Yoshida R, Umeda Y, Yagi T, Fujiwara T. Impact of educational video on performance in robotic simulation training (TAKUMI-1): a randomized controlled trial. J Robot Surg 2023. [PMID: 36905486 DOI: 10.1007/s11701-023-01556-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/01/2023] [Indexed: 03/12/2023]
Abstract
The use of virtual reality for simulations plays an important role in the initial training for robotic surgery. This randomized controlled trial aimed to investigate the impact of educational video on the performance of robotic simulation. Participants were randomized into the intervention (video) group that received an educational video and robotic simulation training or the control group that received only simulation training. The da Vinci® Skills Simulator was used for the basic course, including nine drills. The primary endpoint was the overall score of nine drills in cycles 1-10. Secondary endpoints included overall, efficiency, and penalty scores in each cycle, as well as the learning curves evaluated by the cumulative sum (CUSUM) analysis. Between September 2021 and May 2022, 20 participants were assigned to the video (n = 10) and control (n = 10) groups. The video group had significantly higher overall scores than the control group (90.8 vs. 72.4, P < 0.001). Significantly higher overall scores and lower penalty scores were confirmed, mainly in cycles 1-5. CUSUM analysis revealed a shorter learning curve in the video group. The present study demonstrated that educational video training can be effective in improving the performance of robotic simulation training and shortening the learning curve.
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Feenstra TM, Mak-van der Vossen MC, Schijven MP, Nieveen van Dijkum EJM. Digital Training Resources in the Dutch Surgical Residency Curricula and the Perspectives of Residents: A Thematic Analysis of Resident Interviews. J Surg Educ 2023; 80:457-467. [PMID: 36402731 DOI: 10.1016/j.jsurg.2022.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 10/30/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Digital training resources show great promise in augmenting traditional surgical education - especially in times of social distancing and limited surgical caseload. Embedding digital resources in surgical curricula is however not current, nor common practice in Dutch hospitals. While the digital world has become part of a resident's everyday life, surprisingly little is known about surgical residents' experiences and expectations towards use of digital resources for their own surgical education. This study aims to identify digital resources currently used in Dutch surgical curricula and to describe surgical residents' perspectives towards digital education. METHODS A series of semi-structured interviews with Dutch surgical residents were conducted until data sufficiency occurred. The interviews consisted of two parts: 1) current surgical training and implemented digital resources, and 2) future surgical training and the role of digital resources therein. All interviews were digitally recorded, transcribed verbatim, and thematically analyzed. RESULTS Sixteen surgical residents were interviewed - two out of each of the eight educational regions for surgery in the Netherlands. Five digital resource categories were identified and four general educational themes (requirements, advantages, disadvantages, and general education themes), overarching 13 sub-themes. In general, residents were enthusiastic with regard to using digital resources, especially when the perceived advantages supported their autonomy. CONCLUSIONS Dutch surgical residents indicate that digital resources may support their educational experiences, but state that ideally they must be combined with much appreciated on-the-job training, and be offered to them tailored to their individual needs. No resources are considered to be a "magic bullet" in itself. The specific needs of residents and educators need to be addressed clearly in order to successfully adopt and implement digital resources on a larger scale.
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Affiliation(s)
- Tim M Feenstra
- Amsterdam UMC, University of Amsterdam, Department of Surgery, Amsterdam, North Holland, the Netherlands; Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, Amsterdam, North Holland, the Netherlands; Amsterdam Public Health, Digital Health, Amsterdam UMC, Amsterdam, North Holland, the Netherlands
| | - Marianne C Mak-van der Vossen
- Amsterdam UMC, University of Amsterdam, Department of General Practice, Amsterdam, North Holland, the Netherlands; Amsterdam Public Health research institute University of Amsterdam, Amsterdam, North Holland, the Netherlands
| | - Marlies P Schijven
- Amsterdam UMC, University of Amsterdam, Department of Surgery, Amsterdam, North Holland, the Netherlands; Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, Amsterdam, North Holland, the Netherlands; Amsterdam Public Health, Digital Health, Amsterdam UMC, Amsterdam, North Holland, the Netherlands
| | - Els J M Nieveen van Dijkum
- Amsterdam UMC, University of Amsterdam, Department of Surgery, Amsterdam, North Holland, the Netherlands; Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, Amsterdam, North Holland, the Netherlands; Amsterdam institute for Infection and Immunity, Amsterdam UMC, Amsterdam, North Holland, the Netherlands.
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Cheikh Youssef S, Haram K, Noël J, Patel V, Porter J, Dasgupta P, Hachach-Haram N. Evolution of the digital operating room: the place of video technology in surgery. Langenbecks Arch Surg 2023; 408:95. [PMID: 36807211 PMCID: PMC9939374 DOI: 10.1007/s00423-023-02830-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 02/06/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE The aim of this review was to collate current evidence wherein digitalisation, through the incorporation of video technology and artificial intelligence (AI), is being applied to the practice of surgery. Applications are vast, and the literature investigating the utility of surgical video and its synergy with AI has steadily increased over the last 2 decades. This type of technology is widespread in other industries, such as autonomy in transportation and manufacturing. METHODS Articles were identified primarily using the PubMed and MEDLINE databases. The MeSH terms used were "surgical education", "surgical video", "video labelling", "surgery", "surgical workflow", "telementoring", "telemedicine", "machine learning", "deep learning" and "operating room". Given the breadth of the subject and the scarcity of high-level data in certain areas, a narrative synthesis was selected over a meta-analysis or systematic review to allow for a focussed discussion of the topic. RESULTS Three main themes were identified and analysed throughout this review, (1) the multifaceted utility of surgical video recording, (2) teleconferencing/telemedicine and (3) artificial intelligence in the operating room. CONCLUSIONS Evidence suggests the routine collection of intraoperative data will be beneficial in the advancement of surgery, by driving standardised, evidence-based surgical care and personalised training of future surgeons. However, many barriers stand in the way of widespread implementation, necessitating close collaboration between surgeons, data scientists, medicolegal personnel and hospital policy makers.
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Affiliation(s)
| | | | - Jonathan Noël
- Guy's and St. Thomas' NHS Foundation Trust, Urology Centre, King's Health Partners, London, UK
| | - Vipul Patel
- Adventhealth Global Robotics Institute, 400 Celebration Place, Celebration, FL, USA
| | - James Porter
- Department of Urology, Swedish Urology Group, Seattle, WA, USA
| | - Prokar Dasgupta
- Guy's and St. Thomas' NHS Foundation Trust, Urology Centre, King's Health Partners, London, UK
| | - Nadine Hachach-Haram
- Department of Plastic Surgery, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, UK
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Butterworth S, Hodgkinson EL, Stock NM, Sainsbury DCG, Hodgkinson PD. Evolution of Cleft Lip and Palate Surgical Training in the UK: A Qualitative Study. Cleft Palate Craniofac J 2023; 60:197-210. [PMID: 34786999 DOI: 10.1177/10556656211058443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Although the United Kingdom (UK) cleft surgeons follow a similar training pathway, and cleft centers adhere to similar protocols regarding the timing of palate surgery and surgical technique, speech outcomes still vary between centers. OBJECTIVE To explore the training experiences of consultant cleft lip and palate (CL/P) surgeons, performing a Sommerlad radical intravelar veloplasty (IVVP) and their approach to teaching others. DESIGN An exploratory, qualitative approach was adopted to understand the views of UK cleft surgeons performing a Sommerlad radical IVVP and discuss what was important during training and upon qualifying as a consultant. METHOD A semi-structured interview schedule was designed, interviews were conducted in-person or via videoconferencing, depending on preference and availability, with interested surgeons. The interviews were recorded, transcribed, and checked for accuracy. Analysis involved inductive thematic analysis. RESULTS Fourteen cleft consultants from the UK participated (3F:11M). Seven of the consultants were trained in plastic surgery and four in maxillofacial surgery. Seven themes were identified from the thematic analysis. Three themes, namely Learning to perform palate repair, Teaching others to perform palate repair, and Ongoing learning as a consultant are discussed. CONCLUSIONS Cleft palate repair is clearly a technically challenging procedure to learn and teach with the potential to cause harm if performed incorrectly. Positive changes have been made to improve exposure to palate surgery, encourage practice away from the patient, and increase supervised practical experience. The role of colleagues in providing mentorship and support appears invaluable. We provide some simple recommendations that may improve the training experience and ensure parity for all trainees.
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Affiliation(s)
- Sophie Butterworth
- 5983Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Emma L Hodgkinson
- 5983Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Nicola M Stock
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - David C G Sainsbury
- 5983Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Peter D Hodgkinson
- 5983Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
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Greenberg A, Samueli B, Fahoum I, Farkash S, Greenberg O, Zemser-Werner V, Sabo E, Hagege RR, Hershkovitz D. Short Training Significantly Improves Ganglion Cell Detection Using an Algorithm-Assisted Approach. Arch Pathol Lab Med 2023; 147:215-221. [PMID: 35738006 DOI: 10.5858/arpa.2021-0481-oa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2022] [Indexed: 02/05/2023]
Abstract
CONTEXT.— Medical education in pathology relies on the accumulation of experience gained through inspection of numerous samples from each entity. Acquiring sufficient teaching material for rare diseases, such as Hirschsprung disease (HSCR), may be difficult, especially in smaller institutes. The current study makes use of a previously developed decision support system using a decision support algorithm meant to aid pathologists in the diagnosis of HSCR. OBJECTIVE.— To assess the effect of a short training session on algorithm-assisted HSCR diagnosis. DESIGN.— Five pathologists reviewed a data set of 568 image sets (1704 images in total) selected from 50 cases by the decision support algorithm and were tasked with scoring the images for the presence or absence of ganglion cells. The task was repeated a total of 3 times. Each pathologist had to complete a short educational presentation between the second and third iterations. RESULTS.— The training resulted in a significantly increased rate of correct diagnoses (true positive/negative) and a decreased need for referrals for expert consultation. No statistically significant changes in the rate of false positives/negatives were detected. CONCLUSIONS.— A very short (<10 minutes) training session can greatly improve the pathologist's performance in the algorithm-assisted diagnosis of HSCR. The same approach may be feasible in training for the diagnosis of other rare diseases.
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Affiliation(s)
- Ariel Greenberg
- From Institute of Pathology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (A Greenberg, Fahoum, O Greenberg, Zemser-Werner, Hagege, Hershkovitz)
| | - Benzion Samueli
- From the Department of Pathology, Soroka University Medical Center, Be'er Sheva, Israel (Samueli)
| | - Ibrahim Fahoum
- From Institute of Pathology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (A Greenberg, Fahoum, O Greenberg, Zemser-Werner, Hagege, Hershkovitz)
| | - Shai Farkash
- From the Institute of Pathology, Emek Medical Center, Afula, Israel (Farkash)
| | - Orli Greenberg
- From Institute of Pathology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (A Greenberg, Fahoum, O Greenberg, Zemser-Werner, Hagege, Hershkovitz)
| | - Valentina Zemser-Werner
- From Institute of Pathology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (A Greenberg, Fahoum, O Greenberg, Zemser-Werner, Hagege, Hershkovitz)
| | - Edmond Sabo
- From the Institute of Pathology, Carmel Medical Center, Haifa, Israel (Sabo).,From the Rappaport Faculty of Medicine, Technion, Haifa, Israel (Sabo)
| | - Rami R Hagege
- From Institute of Pathology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (A Greenberg, Fahoum, O Greenberg, Zemser-Werner, Hagege, Hershkovitz).,Hagege and Hershkovitz contributed equally to the research
| | - Dov Hershkovitz
- From the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (Hershkovitz).,Hagege and Hershkovitz contributed equally to the research
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ULLOA G, NEYEM A, ESCALONA G, ORTIZ C, VARAS J. REMOTE ASYNCHRONOUS FEEDBACK FOR UNSUPERVISED LAPAROSCOPIC TRAINING: THE "LAPP" PLATFORM. Arq Bras Cir Dig 2023; 35:e1712. [PMID: 36629690 PMCID: PMC9830672 DOI: 10.1590/0102-672020220002e1712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/16/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND The advantages of laparoscopic surgery over traditional open surgery have changed the surgical education paradigm in the past 20 years. Among its benefits are an improvement in clinical outcomes and patient safety, becoming the standard in many surgical procedures. However, it encompasses an additional challenge due to the complexity to achieve the desired competency level. Simulation-based training has emerged as a solution to this problem. However, there is a relative scarcity of experts to provide personalized feedback. Technology-Enhanced Learning could be a valuable aid in personalizing the learning process and overcoming geographic and time-related barriers that otherwise would preclude the training to happen. Currently, various educational digital platforms are available, but none of them is able to successfully provide personalized feedback. AIMS The aim of this study was to develop and test a proof of concept of a novel Technology-Enhanced Learning laparoscopic skills platform with personalized remote feedback. METHODS The platform "Lapp," a web and mobile cloud-based solution, is proposed. It consists of a web and mobile application where teachers can evaluate remotely and asynchronously exercises performed by students, adding personalized feedback for trainees to achieve a learning curve wherever and whenever they train. To assess the effectiveness of this platform, two groups of students were compared: 130 participants received in-person feedback and 39 participants received remote asynchronous feedback throughout the application. RESULTS The results showed no significant differences regarding competency levels among both groups. CONCLUSION A novel Technology-Enhanced Learning strategy consisting of remote asynchronous feedback throughout Lapp facilitates and optimizes learning, solving traditional spatiotemporal limitations.
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Affiliation(s)
- Gabriel ULLOA
- Pontificia Universidad Católica de Chile, Computer Science Department, School of Engineering – Santiago, Chile
| | - Andres NEYEM
- Pontificia Universidad Católica de Chile, Computer Science Department, School of Engineering – Santiago, Chile
| | - Gabriel ESCALONA
- Pontificia Universidad Católica de Chile, Experimental Surgery and Simulation Center, Department of Digestive Surgery, School of Medicine – Santiago, Chile
| | - Catalina ORTIZ
- Pontificia Universidad Católica de Chile, Experimental Surgery and Simulation Center, Department of Digestive Surgery, School of Medicine – Santiago, Chile
| | - Julian VARAS
- Pontificia Universidad Católica de Chile, Experimental Surgery and Simulation Center, Department of Digestive Surgery, School of Medicine – Santiago, Chile
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Madavan KT. Effectiveness and perception of demonstration-observation- assistance-performance (DOAP) versus video-assisted learning (VAL) in training advanced cardiac life support (ACLS) among medical interns - A comparative study. J Educ Health Promot 2022; 11:412. [PMID: 36824401 PMCID: PMC9942143 DOI: 10.4103/jehp.jehp_1663_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 10/14/2022] [Indexed: 05/30/2023]
Abstract
BACKGROUND Demonstration-Observation-Assistance-Performance (DOAP) and Video-Assisted Learning (VAL) are small-group teaching/learning methods (TLM) in medical education. Comparison studies between the two are scanty. There is a gap in knowledge, skills, and attitude among medical interns toward Advanced Cardiac Life Support (ACLS). The author studied the effectiveness of DOAP and VAL in training ACLS using mannequins and automated external defibrillator (AED)-simulators among interns in 2021. MATERIALS AND METHODS This descriptive study was done in the Emergency Department of a tertiary teaching hospital in South India. Out of 80 medical interns, 39 and 41 were allocated to ACLS training by DOAP (Group 1) and VAL (Group 2), respectively, by convenient sampling with random allocation, with the use of mannequins and AED-Simulators (10 interventions in each small group; three-five participants in each session). Pre-validated pre-test and posttest multiple-choice questionnaires (MCQs) and attitude questionnaires, OSCE by two blinded assessors, and perception by Likert-based questionnaire were analyzed with appropriate statistical analysis. RESULTS The mean pretest and posttest MCQs and Attitude and OSCE scores of DOAP and VAL showed no statistically significant difference between them (MCQ pre-test 44.51 (11.43); 42.54 (6.56); p = 0.350 and MCQ posttest, 78.97 (8.59); 77.22 (11.29); p = 0.438; OSCE 40.51 (2.43) and 40.63 (1.92); p = 0.804; Attitude: 11 (3), 11 (2); p = 0.567; 14 (2), 14 (3); p = 0.095). MCQ post-tests showed improved scores (p < 0.001) in both the methods and the standardized mean difference based on the MCQ scores for the DOAP group was 3.02, and for the VAL group 3, showed the effectiveness of both methods. Perception scores showed learners' interest and positive feedback to both methods and ACLS. CONCLUSION Both DOAP and VAL were equally effective TLMs in imparting knowledge, skills, and attitude to medical interns with positive feedback. In DOAP, the learner performs under supervision and clarifies doubts. As repeatable and cost-effective, VAL is useful in resource-limited settings. Both can be used as complementary methods in training ACLS. The attitude of learners towards ACLS improved with training.
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Larkins K, Mansour K, Costello D, Gray M, Warrier S, Heriot A, Mohan H. Recommendations for the design of video-based educational interventions as instructional tools in robotic surgical training. J Robot Surg 2022; 17:779-784. [DOI: 10.1007/s11701-022-01513-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 12/10/2022] [Indexed: 12/16/2022]
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Alomar AZ. A structured multimodal teaching approach enhancing musculoskeletal physical examination skills among undergraduate medical students. Med Educ Online 2022; 27:2114134. [PMID: 35993497 PMCID: PMC9466621 DOI: 10.1080/10872981.2022.2114134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 08/05/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
Current evidence indicates that undergraduate medical students display deficits in musculoskeletal physical examination skills (MPES). While various instructional methods are recommended for teaching clinical skills, effective methods for teaching MPES have not been established. This study compared the effectiveness of a multimodal teaching approach incorporating video-based learning, interactive small-group teaching, hands-on practicing, peer-assisted learning, formative assessment, and constructive feedback with traditional bedside teaching in developing undergraduate orthopedic MPES. Participants were 151 fifth-year medical students divided into two groups. One group received multimodal teaching, and the other received traditional bedside teaching. In both groups, the participants learned how to physically examine the knee and shoulder. The primary outcome was objective structured clinical examination (OSCE) scores, while the secondary outcomes included teaching sessions' total durations, facilitator's demonstration time, participants' practice time, and proportion of students with passing checklist scores and global ratings-based assessments for the two teaching approaches. The multimodal teaching group had significantly higher OSCE scores (checklist scores, global ratings, and passing rates; p = 0.02, 0.02, 0.01, respectively) than the comparison group. Individual OSCE component assessments showed significant improvements in the special musculoskeletal physical examination test. The overall duration and amount of participants' hands-on time were significantly longer for the multimodal than for the traditional bedside teaching group (p = 0.01 and 0.01, respectively), and the facilitator's demonstration time was significantly shorter (p = 0.01). The multimodal learner-centered teaching approach evaluated in this study was effective for teaching MPES. It appeared to maximize learner engagement through enhancing interactions and providing increased time to engage in hands-on practice. This teaching approach improved MPES levels, maximized teaching efficiency for scenarios with limited instruction time and resources, and enhanced competency of undergraduate medical students in performing special musculoskeletal physical examinations compared to traditional bedside teaching.
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Affiliation(s)
- Abdulaziz Z. Alomar
- Division of Arthroscopy & Sports Medicine, Department of Orthopaedic Surgery, King Saud University, Riyadh, Saudi Arabia
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Mao BP, Teichroeb ML, Lee T, Wong G, Pang T, Pleass H. Is Online Video-Based Education an Effective Method to Teach Basic Surgical Skills to Students and Surgical Trainees? A Systematic Review and Meta-analysis. J Surg Educ 2022; 79:1536-1545. [PMID: 35933308 PMCID: PMC9356715 DOI: 10.1016/j.jsurg.2022.07.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 07/13/2022] [Indexed: 05/11/2023]
Abstract
BACKGROUND Online education has been increasingly utilized over the past decades. The COVID-19 pandemic accelerated the transition of conventional face-to-face curricula to online platforms, with limited evidence for its teaching efficacy. This systematic review aims to assess the effectiveness of online video-based education compared with standard conventional education in teaching basic surgical skills to surgical trainees and students undergoing medical training. METHODS We performed a literature search in Embase, Medline, Cochrane CENTRAL and Scopus from inception until February 2022. Studies included were randomised controlled trials (RCTs) and observational studies. We included randomised controlled trials only for meta-analysis. The primary outcome was surgical skill proficiency. The secondary outcomes were participant perception, confidence and satisfaction. Two authors independently assessed the search results for eligibility, extracted the data and assessed the risk of bias using the Cochrane Risk of Bias tool 2. Where appropriate, we performed random effects meta-analyses of the pooled study data to calculate a standardized mean difference. RESULTS A total of 11 studies met the inclusion criteria totaling 715 participants; 603 were included in qualitative analysis and 380 in meta-analysis. All included studies were assessed as having a low risk of bias. The majority of studies found no significant difference between conventional and video-based education in teaching basic surgical skills, three studies found video-based education was superior and one study found conventional education was superior. There was no statistically significant difference in skill proficiency between the two groups (standardized mean difference of -0.02 (95% CI: -0.34, 0.30); p=0.90). Video-based education results in an equivalent improvement in confidence and satisfaction rates. Additional benefits of video-based education include convenience, accessibility and efficiency. CONCLUSIONS Basic surgical skills can be taught as effectively through online video-based education as conventional teaching methods. Online education should be utilized as an adjunct to medical curricula beyond the COVID-19 era.
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Affiliation(s)
- B P Mao
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - M L Teichroeb
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - T Lee
- Department of Surgery, Westmead Hospital, Sydney, NSW, Australia
| | - G Wong
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Centre for Transplant and Renal Research, Westmead Hospital, Sydney, NSW, Australia
| | - T Pang
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Surgery, Westmead Hospital, Sydney, NSW, Australia
| | - H Pleass
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Surgery, Westmead Hospital, Sydney, NSW, Australia
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Cheikh Youssef S, Hachach-Haram N, Aydin A, Shah TT, Sapre N, Nair R, Rai S, Dasgupta P. Video labelling robot-assisted radical prostatectomy and the role of artificial intelligence (AI): training a novice. J Robot Surg 2022; 17:695-701. [PMID: 36309954 PMCID: PMC9618152 DOI: 10.1007/s11701-022-01465-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/10/2022] [Indexed: 10/31/2022]
Abstract
AbstractVideo labelling is the assigning of meaningful information to raw videos. With the evolution of artificial intelligence and its intended incorporation into the operating room, video datasets can be invaluable tools for education and the training of intelligent surgical workflow systems through computer vision. However, the process of manual labelling of video datasets can prove costly and time-consuming for already busy practising surgeons. Twenty-five robot-assisted radical prostatectomy (RARP) procedures were recorded on Proximie, an augmented reality platform, anonymised and access given to a novice, who was trained to develop the knowledge and skills needed to accurately segment a full-length RARP procedure on a video labelling platform. A labelled video was subsequently randomly selected for assessment of accuracy by four practising urologists. Of the 25 videos allocated, 17 were deemed suitable for labelling, and 8 were excluded on the basis of procedure length and video quality. The labelled video selected for assessment was graded for accuracy of temporal labelling, with an average score of 93.1%, and a range of 85.6–100%. The self-training of a novice in the accurate segmentation of a surgical video to the standard of a practising urologist is feasible and practical for the RARP procedure. The assigning of temporal labels on a video labelling platform was also studied and proved feasible throughout the study period.
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Wu MJ, Knoll RM, Bouhadjer K, Remenschneider AK, Kozin ED. Educational Quality of YouTube Cholesteatoma Surgery Videos: Areas for Improvement. OTO Open 2022; 6:2473974X221120250. [PMID: 36274920 PMCID: PMC9585570 DOI: 10.1177/2473974x221120250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/16/2022] [Indexed: 11/15/2022] Open
Abstract
Otolaryngology surgical education continues to evolve where trainees increasingly use videos to learn technical skills. Trainees commonly use YouTube, but no study to date has evaluated the educational quality (EQ) of otologic surgical videos on YouTube. We aim to assess the EQ of cholesteatoma surgical videos. Cholesteatoma surgical videos were queried using YouTube search terms, assessed using LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS), a validated assessment tool for publication, and categorized into low (0-6), medium (7-12), and high (13-18) EQ groups. In total, 74 videos were identified (mean LAP-VEGaS score = 9.6 ± 4.0) and 44.6% had medium EQ. Videos commonly lacked graphic aids to highlight anatomy (71.6%) and postprocedural outcomes (68.9%). LAP-VEGaS scores were greater in videos originating from US surgeons compared to non-US surgeons (12.4 ± 3.4 vs 8.0 ± 3.5; P < .001). Our study highlights that otolaryngology trainees may experience difficulty finding high-EQ cholesteatoma surgery videos on YouTube. Areas for improved EQ content are discussed. Level of evidence: IV.
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Affiliation(s)
- Matthew J. Wu
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, USA,Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, USA,Elliott D. Kozin, MD, Department of Otolaryngology, Massachusetts Eye and Ear, 243 Charles St, Boston, MA 02114, USA.
| | - Renata M. Knoll
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, USA,Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Karim Bouhadjer
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, USA,Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Aaron K. Remenschneider
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, USA,Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA,Department of Otolaryngology, University of Massachusetts Medical Center, Worcester, Massachusetts, USA
| | - Elliott D. Kozin
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, USA,Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA
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Alshaalan ZM. The Effect of Using Video Simulation and Hands-on Simulation Training on Preclinical Medical Students’ Confidence in Dermatological Suturing Skills. Clin Cosmet Investig Dermatol 2022; 15:2045-2050. [PMID: 36199386 PMCID: PMC9527699 DOI: 10.2147/ccid.s369359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 09/05/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Ziad Mansour Alshaalan
- Department of Internal Medicine, Division of Dermatology, College of Medicine, Jouf University, Sakaka, Aljouf, Saudi Arabia
- Correspondence: Ziad Mansour Alshaalan, Department of Internal Medicine, Division of Dermatology, College of Medicine, Jouf University, Sakaka, Aljouf, 72388, Saudi Arabia, Tel +966-566000909, Email
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Vázquez Gómez M, Galipienso Eri M, Hernández Martínez A. [Translated article] Has 2020 been a lost year in orthopaedic surgery and trauma training? Residents’ perceptions. Rev Esp Cir Ortop Traumatol (Engl Ed) 2022; 66:T397-T402. [PMID: 35843551 PMCID: PMC9281451 DOI: 10.1016/j.recot.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/13/2021] [Indexed: 11/28/2022] Open
Abstract
Objective The COVID-19 pandemic has affected specialised healthcare training at all levels. Surgical learning has been severely affected, and the impact on orthopaedic surgery residency training has so far not been assessed. Material and methods An online survey of 17 questions was sent via web link to orthopaedic surgery residents throughout Spain between February 10, 2021 and February 28, 2021. The effects of the COVID-19 pandemic on the care and training activities of residents were analysed. Results A total of 307 orthopaedic surgery residents from all over Spain responded to the online survey. A total of 77.2% of the respondents had to suspend their rotations. Of these, 67.5% would like to resume the rotations they missed during the pandemic. A total of 69.7% of scheduled surgeries were suspended. Surgical activity was completely stopped for an average of 8 weeks. 66.8% of the residents consider that their surgical training has been affected and this will have repercussions on their future work. 49.5% considered the online training offered to be insufficient. Of the total number of respondents, 52.1% considered that the impact of the pandemic situation on their training situation was bad or very bad. Conclusions The data collection shows a negative impact on both theoretical and clinical training. This study highlights the need to continue offering quality training by maximising learning opportunities.
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Srinivasa K, Moir F, Goodyear-Smith F. The Role of Online Videos in Teaching Procedural Skills in Postgraduate Medical Education: A Scoping Review. J Surg Educ 2022; 79:1295-1307. [PMID: 35725724 DOI: 10.1016/j.jsurg.2022.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 04/27/2022] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The purpose of this scoping review was to outline the extent of available literature including the prevalence of video quality appraisal tools, characterize how online videos were used, and identify the gaps in the literature with implications for future research. DESIGN The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for scoping reviews (PRISMA-ScR). Six databases were searched: (1) MEDLINE (Ovid), (2) EMBASE, (3) Cochrane, (4) ERIC, (5) CINAHL PLUS, and (6) Google Scholar for Medical Subject Headings terms online videos, postgraduate health education, and health professional/s. RESULTS A total of 6948 articles were identified, of which 78 were included in the review. The articles included were primarily either experimental or observational studies, with most being from North America. Twelve concepts were identified: (1) procedural skills teaching; (2) video assessment; (3) validation of an assessment tool; (4) video feedback; (5) coaching; (6) broadcasting; (7) learner characteristics; (8) video characteristics; (9) video quality; (10) a quality assessment tool; (11) platforms and video library; and (12) health information governance. CONCLUSIONS While there is a diverse and growing body of literature on this area, information is lacking about the quality appraisal of online videos.
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Affiliation(s)
- Komal Srinivasa
- Department of General Practice & Primary Health Care, University of Auckland, Auckland, New Zealand.
| | - Fiona Moir
- Department of General Practice & Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Felicity Goodyear-Smith
- Department of General Practice & Primary Health Care, University of Auckland, Auckland, New Zealand
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Gill BC. EDITORIAL COMMENT. Urology 2022; 167:42. [PMID: 36153103 DOI: 10.1016/j.urology.2022.02.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 02/27/2022] [Indexed: 11/02/2022]
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Uprak TK, Ergenç M. Assessment of Esophagectomy Videos on YouTube: Is Peer Review Necessary for Quality? J Surg Res 2022; 279:368-73. [PMID: 35820318 DOI: 10.1016/j.jss.2022.06.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Various online platforms, such as YouTube, are used for surgical education. Esophageal surgery is sophisticated and surgical videos may help reduce the time it takes for surgeons to learn these complicated operations. There is no clear consensus regarding the quality and reliability of esophagectomy videos on YouTube. We aimed to evaluate esophageal surgery videos published on YouTube in terms of quality and reliability. METHODS The keywords "esophagectomy" and "surgery" were both searched on YouTube and the first 150 results were evaluated. Eighty two videos were included in the analysis. The quality and reliability of the videos were determined using the esophagectomy scoring system (ESS) developed by the authors, the Journal of the American Medical Association benchmark criteria, and the video power index. RESULTS A total of 82 videos were reviewed. About two-thirds of the videos demonstrated the Ivor Lewis technique and included surgeries performed using the thoracoscopic/laparoscopic method. The videos were analyzed as per the source of the upload: academic (25.7%), industry-sponsored (9.7%), or individual (64.6%). When the scores were compared by the origin of the videos, industry-sponsored videos scored significantly higher than the videos produced by individuals and academic centers (P = 0.01). While the ESS and Journal of the American Medical Association benchmark criteria scores were significantly correlated (P = 0.00), no correlation was found between video length, video power index score, and ESS score. CONCLUSIONS Conducting a professional evaluation of videos before they are published on YouTube may enhance video quality. Moreover, valuable videos of better quality can be produced by improving the ESS and by assessing more videos.
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Doğan Değer M, Alperen Yıldız H, Denizhan Demirkıran E, Madendere S. Current status of urological training and differences between institutions. Actas Urol Esp 2022; 46:285-292. [PMID: 35177364 DOI: 10.1016/j.acuroe.2022.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/26/2021] [Accepted: 05/23/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Appropriate training of urology residents is important to secure not only high-quality patient care, but also the bright future of our specialty. We aimed to investigate residency training from the perspective of qualification and standardization and to evaluate surgical education, publication output, working conditions, future plans, and overall satisfaction, in a comprehensive way. METHODS We conducted a survey of urology chief residents/recent graduates in Turkey to identify differences between institutions and deficiencies in urology resident training. A total of 155 chief residents/recently graduated specialists were contacted by phone and a survey was completed. RESULTS The survey response rate was 96.1%. Respondents had high proficiency in endourology (97.3%), similar to Canada and European countries. However, they reported a lack of proficiency in laparoscopy (28.9%) and functional urology (26.2%). Also, no one had completed a robotic procedure as first surgeon. A total of 75.2% respondents had no first author publication, and 10.1% had no first author abstract presentation. There was no significant difference between institution types with or without certification. There was a satisfaction rate of 87.2% among participants. CONCLUSIONS It was observed that qualified and standardized training could has not been achieved and the positive effects of certification have not been seen yet. There is a lack of modernization in all aspects of education, and there is no standardized curriculum addressing academic research. Therefore, there is a risk that future urologists will have insufficient skills. We hope this study serves as a guide for modernization and standardization in urology training.
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Affiliation(s)
- M Doğan Değer
- Departamento de Urología, Hospital Edirne Sultan 1(er) Murat, Edirne, Turkey.
| | | | | | - S Madendere
- Departamento de Urología, Hospital Gümüşhane, Gümüşhane, Turkey
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Roque DR, Hinchcliff E, Alter R, Barber EL, Marcus J, Tanner E. Surgical Training in Gynecologic Oncology:A Sea Change. J Gynecol Surg 2022. [DOI: 10.1089/gyn.2022.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Dario R. Roque
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, USA
- Robert H Lurie Comprehensive Cancer Center Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Emily Hinchcliff
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, USA
- Robert H Lurie Comprehensive Cancer Center Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Raanan Alter
- Northwestern Medicine Central DuPage Hospital, Winfield, Illinois, USA
| | - Emma L. Barber
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, USA
- Robert H Lurie Comprehensive Cancer Center Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Jenna Marcus
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, USA
- Robert H Lurie Comprehensive Cancer Center Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Northwestern Medicine Central DuPage Hospital, Winfield, Illinois, USA
| | - Edward Tanner
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, USA
- Robert H Lurie Comprehensive Cancer Center Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Tudor Car L, Poon S, Kyaw BM, Cook DA, Ward V, Atun R, Majeed A, Johnston J, van der Kleij RMJJ, Molokhia M, V Wangenheim F, Lupton M, Chavannes N, Ajuebor O, Prober CG, Car J. Digital Education for Health Professionals: An Evidence Map, Conceptual Framework, and Research Agenda. J Med Internet Res 2022; 24:e31977. [PMID: 35297767 PMCID: PMC8972116 DOI: 10.2196/31977] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/07/2021] [Accepted: 11/21/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Health professions education has undergone major changes with the advent and adoption of digital technologies worldwide. OBJECTIVE This study aims to map the existing evidence and identify gaps and research priorities to enable robust and relevant research in digital health professions education. METHODS We searched for systematic reviews on the digital education of practicing and student health care professionals. We searched MEDLINE, Embase, Cochrane Library, Educational Research Information Center, CINAHL, and gray literature sources from January 2014 to July 2020. A total of 2 authors independently screened the studies, extracted the data, and synthesized the findings. We outlined the key characteristics of the included reviews, the quality of the evidence they synthesized, and recommendations for future research. We mapped the empirical findings and research recommendations against the newly developed conceptual framework. RESULTS We identified 77 eligible systematic reviews. All of them included experimental studies and evaluated the effectiveness of digital education interventions in different health care disciplines or different digital education modalities. Most reviews included studies on various digital education modalities (22/77, 29%), virtual reality (19/77, 25%), and online education (10/77, 13%). Most reviews focused on health professions education in general (36/77, 47%), surgery (13/77, 17%), and nursing (11/77, 14%). The reviews mainly assessed participants' skills (51/77, 66%) and knowledge (49/77, 64%) and included data from high-income countries (53/77, 69%). Our novel conceptual framework of digital health professions education comprises 6 key domains (context, infrastructure, education, learners, research, and quality improvement) and 16 subdomains. Finally, we identified 61 unique questions for future research in these reviews; these mapped to framework domains of education (29/61, 47% recommendations), context (17/61, 28% recommendations), infrastructure (9/61, 15% recommendations), learners (3/61, 5% recommendations), and research (3/61, 5% recommendations). CONCLUSIONS We identified a large number of research questions regarding digital education, which collectively reflect a diverse and comprehensive research agenda. Our conceptual framework will help educators and researchers plan, develop, and study digital education. More evidence from low- and middle-income countries is needed.
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Affiliation(s)
- Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Selina Poon
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Bhone Myint Kyaw
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - David A Cook
- Office of Applied Scholarship and Education Science, School of Continuous Professional Development, Mayo Clinic College of Medicine and Science, Division of General Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Victoria Ward
- Department of Pediatrics, Lucile Packard Children's Hospital, Stanford, CA, United States
| | - Rifat Atun
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard, Boston, MA, United States
| | - Azeem Majeed
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Jamie Johnston
- Stanford Center for Health Education's Digital MedIC Initiative, Stanford School of Medicine, Stanford University, Stanford, CA, United States
| | | | - Mariam Molokhia
- School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Florian V Wangenheim
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Martin Lupton
- Faculty of Medicine, Imperial College London, London, United Kingdom.,The Chelsea and Westminster Hospital, Chelsea, London, United Kingdom
| | - Niels Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Onyema Ajuebor
- Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - Charles G Prober
- Stanford Center for Health Education's Digital MedIC Initiative, Stanford School of Medicine, Stanford University, Stanford, CA, United States
| | - Josip Car
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom.,Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Vindal A, Lal P. Measurement and Accreditation of Minimal Access Surgical Skills: Challenges and Solutions. Indian J Surg. [DOI: 10.1007/s12262-022-03319-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Doğan Değer M, Alperen Yıldız H, Denizhan Demirkıran E, Madendere S. Estado actual de la formación urológica y diferencias entre instituciones. Actas Urol Esp 2022. [DOI: 10.1016/j.acuro.2021.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wiedenmann C, Wacker K, Böhringer D, Maier P, Reinhard T. [Online examination course instead of classroom teaching: adaptation of medical student teaching during the COVID-19 pandemic]. Ophthalmologe 2022; 119:11-18. [PMID: 33825052 PMCID: PMC8023559 DOI: 10.1007/s00347-021-01372-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic restricted face-to-face interactions of medical students and teachers. OBJECTIVE To develop and evaluate an online course for ophthalmology examination techniques for medical students and to determine the impact of the course on the practical objective structured clinical examination (OSCE). MATERIAL AND METHODS The online examination course was developed as a video-based tutorial according to the SMART (specific, measurable, activating, reasonable, time-bound) principle covering all topics of the National Competency-based Catalogue of Learning Objectives for Medical Education and made available to medical students in the ophthalmology course. At the end of the semester the students graded the online examination course on an ordinal scale from 1 (strongly agree) to 6 (strongly disagree) anonymously and were asked for comments. The grades of the OSCE (range 1-5) were compared with the OSCE results of the previous semester. RESULTS Of the 164 students 67 participated in the online evaluation (41%). The students reported to be well-prepared for the OSCE (mean grade 2.0; SD 1.0). In the future, 70% of the students would prefer combined online and on-site teaching (47 out of 67 students). Among all 164 students, the mean OSCE results were excellent (mean grade 1.1; SD 0.2) and comparable to the previous semester (mean grade among 166 students, 1.1; SD 0.2; two-sided t-test, p = 0.86). CONCLUSION The online course on ophthalmology examination techniques allowed medical students to prepare for the OSCE. Beyond the COVID-19 pandemic, online teaching options can support on-site teaching.
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Affiliation(s)
- Cornelius Wiedenmann
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - Katrin Wacker
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - Daniel Böhringer
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - Philip Maier
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland.
| | - Thomas Reinhard
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
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Chorath KT, Luu NN, Douglas JE, Yver CM, Thakkar PG, Tasche KK, Rajasekaran K. Assessment of YouTube as an educational tool in teaching thyroidectomy and parathyroidectomy. J Laryngol Otol 2021;:1-26. [PMID: 34895376 DOI: 10.1017/S0022215121004096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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50
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Farr E, Roth E. Virtual Learning in Graduate Medical Education: Applying Learning Theory for Effective Educational Videos. J Grad Med Educ 2021; 13:757-760. [PMID: 35070084 PMCID: PMC8672832 DOI: 10.4300/jgme-d-21-00245.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Ellen Farr
- Ellen Farr, MD, is a PGY-5 Fellow, Department of Physical Medicine and Rehabilitation, Division of Brain Rehabilitation, Mayo Clinic College of Medicine and Science
| | - Elliot Roth
- Elliot Roth, MD, is the Paul B. Magnuson Professor and Chairman, Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, and Attending Physician, Brain Innovation Center, Shirley Ryan AbilityLab
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